Responsiveness and Satisfaction with Providers and Carriers in a Safety Net Insurance Program

Evidence from Georgia's Medical Insurance for the Poor

Published in: Health Policy, v. 102, no. 2-3, Oct. 2011, p. 286-294

Posted on RAND.org on October 01, 2011

by Sebastian Bauhoff, David R. Hotchkiss, Owen Smith

Read More

Access further information on this document at Health Policy

This article was published outside of RAND. The full text of the article can be found at the link above.

OBJECTIVE: To evaluate provider responsiveness and beneficiary satisfaction with insurance carriers participating in the Republic of Georgia's Medical Insurance for the Poor. STUDY SETTING: A dedicated survey of approximately 3500 households in two types of regions – with different eligibility thresholds – in November and December 2008. STUDY DESIGN: Regression-based estimation of responsiveness ratings by beneficiaries and non-beneficiaries of the insurance program and estimation of mean satisfaction scores for beneficiaries. PRINCIPAL FINDINGS: 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.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.