Choosing the right PPP model

Abstract

Because of the diversity in the structure of national healthcare systems, the objectives set for PPP policies differ between jurisdictions. This chapter focuses on the different PPP models used across the world to fund investments in physical capital in the healthcare sector, such as hospital buildings and technology, and also those used to provide non-core and clinical services. It provides an analysis of the different contractual structures and dominant payment mechanisms used, and for each model presents some relevant cases. The models analysed in the chapter are as follows: Turnkey contracts (DBF and BLT) for building new healthcare infrastructure; managed equipment services (MES) for medical equipment; operation and maintenance (O&M) contracts for the management of non-core services (such as energy management); availability based contracts (DBFMO) contracts for building new hospitals (and their evolution towards the so-called "light model") and BOT/oncession contracts, which may include healthcare infrastructure but are focused on the delivery of clinical services.