Smith, Owen2013-05-012013-05-012013-01https://hdl.handle.net/10986/13282Georgia launched its Medical Insurance Program (MIP) for the poor in 2006. This program draws from general tax revenues to provide comprehensive, means-tested health insurance to the poorest 20 percent of the population as identified by a proxy means test. The government contracts private insurance companies who serve as financial risk carriers and purchasing agents for the program. MIP is well targeted to the poor and has had a major impact on improving financial protection of its beneficiaries. It has also served as a launching pad for significant investments in hospitals and information technology (IT) systems. In brief, MIP is a program funded through general taxation that provides a fairly comprehensive benefits package of health services to the poorest 20 percent of the population as identified via a proxy means test. There are no copayments for services. Although run by a state purchaser during the first two years, since 2008 its key feature has been that private insurance companies are contracted by the Ministry of Health to bear financial risk and to purchase services from both public and private providers on behalf of poor beneficiaries. The government sets policy, pays a per capita premium per beneficiary to private insurers, and conducts program oversight. This case study provides an overview of how MIP is designed, its achievements to date, and challenges for the future. A key theme discussed in further detail, and of potential interest to other countries contemplating a push toward the achievement of universal health coverage, is the contracting of private insurance companies to purchase services on behalf of the poor. Some attention is also given to MIP's targeting approach.en-USCC BY 3.0 IGOaccess to servicesadministrative costsAdult mortalityAdult mortality rateagedagentsapplicationsBeneficiariescapitationcardiovascular diseasechemotherapychild deliverychild healthcivil conflictCommunicable diseasescommunity participationcompetitive biddingcontraceptionContraceptive prevalencecontracts with providerscost-effectivenesscosts of caredelivery costsdelivery of health careDependency ratiodepressiondeveloping countriesdiabetesdisease risk factorsdoctorseconomic growthemergency careemploymentessential drugsfee-for-servicefertilityfertility ratefinance managementFinancial Managementfinancial protectionfinancial riskfinancial risksfraudgovernment supportgross domestic productgroup insurancehealth behaviorhealth carehealth care resourceshealth care serviceshealth care utilizationHealth CoverageHealth Economicshealth expenditurehealth expendituresHealth Financinghealth indicatorshealth insurancehealth maintenancehealth maintenance organizationhealth maintenance organizationshealth outcomesHealth Policyhealth promotionhealth reformhealth sectorhealth serviceshealth spendinghealth statusHealth SystemHealth System Financinghealth system strengtheninghealth systemsHealth Systems in Transitionhealth workershealthcare serviceshigh blood pressureHIV/AIDSHMOHMOshospitalhospital bedshospital systemhospitalizationhospitalsill healthillnessesimmunizationimpact on healthincomeincome countriesInfantInfant mortalityInfant mortality rateinfectious diseasesinformal paymentsinpatient careInsuranceInsurance Companiesinsurance industryinsurance marketsintegrationlab testslife expectancyLife expectancy at birthlive birthsliving conditionsloss ratiomarketingMaternal mortalityMaternal mortality rateMedical careMedical care costsMedical Insurancemedical servicesmentalmental healthmental health caremidwivesMinistry of Healthminoritymonthly premiummorbiditymortalitymultiple insurance systemsmultiple insurersnational governmentNeonatal mortalityNursesoutpatient careoutpatient servicespatientPatientspensionspharmaceutical spendingpharmaciespharmacyphysicianphysicianspocket paymentpocket paymentsPolicy Implicationspopulation groupspregnant womenprenatal careprices of health servicesprimary careprimary care doctorprimary care doctorsprimary health carePrivate Health InsurancePrivate InsurancePrivate Insurance Companiesprivate insurerprivate insurersprogramsprogressprovider paymentprovision of carepsychiatryPublic Expenditurepublic healthPublic health expenditurepublic health systempublic hospitalspublic providerspurchasing powerquality of careradiationreimbursement ratesrespectrisk factorsrural areassafety netsanitationsanitation facilitiesservice deliveryservice provisionSkilled birth attendanceSocial AffairsSocial Assistancesocial sectorSocial ServicessurgeryTuberculosisuniversal accessurban developmentwomanworkersworking-age populationWorld Bank10.1596/13282