Georgia

The introduction of the Universal Health Coverage Programme (UHCP) in 2013 extended the breadth of coverage to almost the whole population in Georgia, only a fifth of whom had comprehensive health coverage before then.

The Georgian health system has moved strongly away from the Semashko model it inherited at independence. The system is now highly decentralized and has been extensively privatized.  

Under the UHCP, financial access to care has improved by reducing out-of-pocket (OOP) spending on health services. OOP spending is dominated by spending on outpatient pharmaceuticals and recent reforms have focused on improving access to essential medicines. 

Under the UHCP, patients have almost unlimited choice of provider for emergency, elective treatment and primary care; however, the provision of patient information to inform such choice of provider is limited. Primary care doctors only act as gatekeepers for patients covered under relevant parts of the UHCP or private insurance. Specialized care in Georgia is provided by secondary and tertiary care institutions – general multi-profile and referral hospitals, scientific-research institutes, specialized hospitals and specialized clinics (dispensaries). Very few hospitals are in public ownership as successive waves of reforms have increased the autonomy of hospitals, with full-scale privatization occurring between 2008 and 2012.