An Evaluation of the Initial Impact of the Medical Assistance Program for the Poor in Georgia

Abstract

As part of the recent health reform
 effort, the government of Georgia launched a Medical
 Assistance Program in June 2006 to provide health insurance
 to its poor population. So far the program covers slightly
 over 50 percent of the poor and provides benefit coverage
 for outpatient and inpatient care. This paper estimates
 initial impact of the Medical Assistance Program and
 assesses whether the benefits have reached the poorest among
 those eligible, using utilization data from June 2006 to
 December 2006. Based on the analysis using a regression
 discontinuity design and a three-part model, the paper
 presents two main findings. First, the Medical Assistance
 Program has significantly increased utilization of acute
 surgeries/inpatient services by the poor. Second, the
 benefits have successfully reached the poorest among the
 poor. These two findings indicate that government efforts
 to improve the poor's access to and utilization of
 health services are yielding results. The paper emphasizes
 that the initial dramatic increase in surgeries must be
 interpreted with caution, given the possible
 misclassification or misreporting of acute surgeries in the
 data. The paper also stresses the need to continue
 monitoring implementation of the Medical Assistance Program
 and further improve program design, particularly the
 targeting mechanism, to achieve better efficiency,
 effectiveness and overall equity in access to health care services.