Vecchi / Hellowell Public-Private Partnerships in Health

Improving Infrastructure and Technology
1. Auflage 2018
ISBN: 978-3-319-69563-1
Verlag: Springer Nature Switzerland
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 118 Seiten

Reihe: Progress in Mathematics

This book considers the use of Public-Private Partnerships (PPPs) in the delivery of physical assets, infrastructure and technologies and related clinical services, in the health sector. The PPP model represents the most complex form of contracting transaction yet to have emerged in the health sector, owing to its long-term character, financial complexity, and risk-allocation mechanisms. This book draws on the lessons of policy-makers, managers and private companies to address the specific challenges in the health sector. It is the reference guide to PPPs in health, presenting the theory, evidence and practice, and making them operationally relevant to all PPP stakeholders.

Veronica Vecchi is Professor of Public Management and Business Government Relations at Bocconi University School of Management (SDA Bocconi), Italy. 
Mark Hellowell is Senior Lecturer at the University of Edinburgh, UK, where his research focuses on the public/private interface in healthcare financing and services.

Autoren/Hrsg.

Vecchi, Veronica

Hellowell, Mark

Inhaltsverzeichnis

1;Contents;6
2;List of Figures;7
3;List of Tables;8
4;Introduction;9
5;Chapter 1: Public Private Partnerships and the Quality and Efficiency of Healthcare Services;11
5.1;1.1 Introduction;12
5.2;1.2 Benefits from Public Private Partnerships in the Health Sector;12
5.3;1.3 Sources of Additional Costs;14
5.4;1.4 What Determines the Benefits and Costs?;16
5.5;1.5 Investment Decisions and Affordability;17
5.6;1.6 Conclusion;19
5.7;References;21
6;Chapter 2: Choosing the Right PPP Model;24
6.1;2.1 Introduction;25
6.2;2.2 Defining the Main PPP Models;26
6.2.1;2.2.1 Turnkey Contracts (BF, DBF and BLT);29
6.2.2;2.2.2 Operation and Maintenance Contracts;31
6.2.3;2.2.3 Managed Equipment Service (MES) Contracts;32
6.2.4;2.2.4 Availability-Based Contracts (DBFMO, DBFM);38
6.2.5;2.2.5 Concession Contracts;45
6.3;Bibliography;50
7;Chapter 3: The Key Element of PPP: Risk;52
7.1;3.1 Risks in PPP Contracts and the Risk Matrix;53
7.2;3.2 Contract Qualification and Accounting;61
7.3;3.3 Risk and Value for Money;65
7.4;References;72
8;Chapter 4: Principles of Capital Budgeting for the Assessment of PPP Projects;74
8.1;4.1 Introduction;75
8.2;4.2 Capital Budgeting Tools;76
8.2.1;4.2.1 Pro-forma Financial Statements;77
8.2.1.1;4.2.1.1 Cash Flow Calculation;78
8.2.1.2;4.2.1.2 The Time Distribution and Value of Cash Flows;82
8.2.2;4.2.2 Profitability Ratios: NPV, IRR and the Appropriate Cost of Capital;82
8.2.2.1;4.2.2.1 The Appropriate Cost of Capital;85
8.2.3;4.2.3 Cover Ratios: DSCR;87
8.2.4;4.2.4 Sensitivities;88
8.3;4.3 The Economic and Financial Equilibrium in PPP Transactions;90
8.4;4.4 The Renegotiation of the Contract and the Restoration of Economic and Financial Equilibrium;91
8.5;References;93
9;Chapter 5: Assessing the Cost of Capital for PPP Contracts;94
9.1;5.1 Introduction;95
9.2;5.2 The Cost of Equity: A Conceptual Framework;95
9.3;5.3 How the Market Really “Thinks”;99
9.4;5.4 Applying the CAPM to PPPs in Real-World Markets;100
9.4.1;5.4.1 Estimating the Risk-Free Interest Rate;101
9.4.2;5.4.2 Estimating Beta;102
9.4.3;5.4.3 Estimating the Equity Market Risk Premium;105
9.5;5.5 Risks in PPP Transactions and Determining the Cost of Equity;109
9.5.1;5.5.1 Estimating the Cost of Equity, Step by Step;110
9.6;5.6 Conclusion;115
9.7;References;117