Gov’t launches new healthcare methodology for fairer services, controlled hospital costs

Georgian health minister Zurab Azarashvili on Tuesday announced the launch of a diagnosis-related group methodology. Photo: health ministry press office, 25 Oct 2022 - 16:46, Tbilisi,Georgia

Georgian health minister Zurab Azarashvili on Tuesday announced the launch of a new methodology for clinics involved in the state-funded general healthcare programme, in a bid to offer improved treatment efficiency and prevent patient over-treatment in medical services.

The diagnosis-related group methodology will be used at clinics across the country starting next month, and will categorise patients with similar clinical diagnoses in order to better control hospital costs and determine payer reimbursement rates. 

Describing the methodology as the “most fair, correct and proven system of medical services”, the health minister claimed the new model was expected to ensure “fundamental improvements” in the quality of medical services. 

After the launch of the methodology, clinics will have no motivation to conduct unnecessary interventions on patients for [ensuring] higher incomes. Unfortunately, we have had such cases”, he said. 

Azarashvili added there had been several attempts since the 1990s to launch the system in the country, with Georgian Dream authorities “working intensively” since 2016 to assign codes and develop the correct calculation mechanism for the launch of the methodology. 

We took further steps in January to prepare the system and we are ready to launch it starting November 1”, he noted, adding “clinics will no longer charge patients any additional ‘out-of-pocket costs' other than [the rates] determined by the system”. 

The minister also announced a transfer of funding of costs for oncological illnesses from the referral system to the general healthcare programme, with the annual limit for a patient increased from ₾20,000 ($7,142) to ₾25,000 ($8,928).