title: Responsiveness and satisfaction with providers and carriers in a safety net insurance program: evidence from Georgia's Medical Insurance for the Poor.
abstract: OBJECTIVE
  To evaluate provider responsiveness and beneficiary satisfaction with insurance carriers participating in the Republic of Georgia's Medical Insurance for the Poor.
  
  
  METHODS
  A dedicated survey of approximately 3500 households in two types of regions--with different eligibility thresholds--in November and December 2008.
  
  
  METHODS
  Regression-based estimation of responsiveness ratings by beneficiaries and non-beneficiaries of the insurance program and estimation of mean satisfaction scores for beneficiaries.
  
  
  RESULTS
  In the high-threshold regions, provider responsiveness toward beneficiaries and non-beneficiaries is comparable. In the low-threshold regions, beneficiary status is associated with lower responsiveness of outpatient providers. Inpatient providers may have become less responsive toward beneficiaries during the program's transition from public to private administration. While satisfaction of beneficiaries with carriers is above average, there are reports of difficulties in obtaining reimbursements and information about benefits.
  
  
  CONCLUSIONS
  The results suggest that relying on private insurance companies to deliver public programs in middle-income settings may impact provider responsiveness and indicate the need for continuous monitoring and regulation.
authors.affiliation: Department of Health Care Policy, Harvard University, Boston, MA, USA. bauhoff@post.harvard.edu
authors.forename: Sebastian
authors.initials: S
authors.lastname: Bauhoff
authors.forename: David R
authors.initials: DR
authors.lastname: Hotchkiss
authors.forename: Owen
authors.initials: O
authors.lastname: Smith
mesh_terms: D003258:Consumer Behavior; D003906:Developing Countries; D005846:Georgia (Republic); D006291:Health Policy; D006801:Humans; D007343:Insurance Carriers; D019458:Insurance Coverage / Q000191:economics*; D007348:Insurance, Health / Q000191:economics*; D009313:National Health Programs; D011050:Policy Making; D011203:Poverty; D017149:Private Sector / Q000191:economics; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires; D019472:Universal Health Insurance