The scientific paper “Managed Competition and Health Insurance Reforms in Georgia” by Caucasus
University professor Tengiz Verulava was published in the international refereed journal “Bulletin of the
Georgian National Academy of Sciences” Tengiz Verulava (2023).
Managed Competition and Health Insurance Reforms in Georgia. Bulletin of the Georgian National Academy of Sciences. 17(1):175-180 [Link] [Google Scholar] The journal is indexed in the SCOPUS international scientific database.
Article link - http://science.org.ge/bnas/vol-17-1.html
Annotation
The increase in health care costs is one of the main problems of the health care policy, the effective
mechanism for solving which is the competitive system of health care financing. In a competitive system, state healthcare programs are managed not by one organization, but by many paying entities (insurance companies), which creates competition between them. In turn, the state regulates competition to achieve social goals. Such a symbiosis of competition and regulation is called managed competition. The competitive insurance model increases the free choice of the insurer by the insured, the quality of medical services, has a positive effect on the effective management of state healthcare programs, the containment of the growth of healthcare costs, the transparency of insurance products and the awareness of the insured. The purpose of the paper is to study the features of the development of the competitive insurance model in the Georgian healthcare system. As a result of the reforms implemented in the healthcare system of Georgia in 2008-2010, a competitive insurance system was introduced.
However, since 2010, the competition between insurance companies has been replaced by a monopoly
insurance system in the respective district. As a result of the transition from the competitive insurance
model to the district monopoly insurance model, the right of the users of the state health care program
to freely choose both the insurer and the provider was limited, which negatively affected the
satisfaction of the insured.
