Maia Makharashvili, Chair of the Supervisory Board at the Healthcare Association, stated that while the transition to the DRG (Diagnosis-Related Groups) funding system was necessary, it must be accompanied by ongoing review, but this process has not been fully implemented.
Speaking on “Analytics,” Makharashvili emphasized that the DRG system, introduced in Georgia in November 2022, has brought significant improvements.
"The transition to the DRG funding system is very positive and necessary because the previous system was very chaotic. While it might not be perfect, it is a globally recognized model. DRG has simplified administration to a degree. Previously, there was a huge list of procedures funded either by the state or directly by patients. Now, it’s more structured and fixed. Moreover, the regulation ensuring that patients no longer pay above the DRG tariff positively impacts them: they no longer have to make choices based on cost, and co-payment limits are effectively standardized," she said.
Makharashvili added that while the sector welcomed a more accurate funding mechanism, the system requires constant monitoring, adjustments, and close communication.
"The DRG process should not be one-time; it must be continuously updated. Over the past three years, data have accumulated. The initial data used to start the DRG system was somewhat unreliable. Today, data quality is better, and using three years of information, it is highly relevant to review and make corrections. Adjustments should balance budget efficiency with fair, adequate funding under each tariff," she concluded.
