Scribd Logo
Upload

Welcome to Scribd!

  • 47 views

    Dinah Roberts Build and Beyond PWC

    Uploaded by

    Hamdi Boyaci
    This document discusses the evolution and revolution of public-private partnerships (PPPs) in healthcare. PPPs initially focused on building and renovating infrastructure but have expanded to include clinical service delivery. Healthcare spending is growing significantly which increases the need for alternative financing models like PPPs. Integrated PPP models that include both infrastructure and clinical services show the most potential for cost savings of up to 45% of total health spending. Case studies from the UK and Abu Dhabi demonstrate how PPPs are playing an increasingly complex role in healthcare systems around the world.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Dinah Roberts Build and Beyond PWC

    Uploaded by

    Hamdi Boyaci
    47 views17 pages
    This document discusses the evolution and revolution of public-private partnerships (PPPs) in healthcare. PPPs initially focused on building and renovating infrastructure but have expanded to include clinical service delivery. Healthcare spending is growing significantly which increases the need for alternative financing models like PPPs. Integrated PPP models that include both infrastructure and clinical services show the most potential for cost savings of up to 45% of total health spending. Case studies from the UK and Abu Dhabi demonstrate how PPPs are playing an increasingly complex role in healthcare systems around the world.

    Original Title

    Dinah Roberts Build and Beyond PwC

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses the evolution and revolution of public-private partnerships (PPPs) in healthcare. PPPs initially focused on building and renovating infrastructure but have expanded to include clinical service delivery. Healthcare spending is growing significantly which increases the need for alternative financing models like PPPs. Integrated PPP models that include both infrastructure and clinical services show the most potential for cost savings of up to 45% of total health spending. Case studies from the UK and Abu Dhabi demonstrate how PPPs are playing an increasingly complex role in healthcare systems around the world.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    47 views17 pages

    Dinah Roberts Build and Beyond PWC

    Uploaded by

    Hamdi Boyaci
    This document discusses the evolution and revolution of public-private partnerships (PPPs) in healthcare. PPPs initially focused on building and renovating infrastructure but have expanded to include clinical service delivery. Healthcare spending is growing significantly which increases the need for alternative financing models like PPPs. Integrated PPP models that include both infrastructure and clinical services show the most potential for cost savings of up to 45% of total health spending. Case studies from the UK and Abu Dhabi demonstrate how PPPs are playing an increasingly complex role in healthcare systems around the world.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 17

    www.pwc.

    com

    Build and Beyond: The (R)evolution of Healthcare PPPs May 2011

    Agenda & Speakers


    Dinah Rowe-Roberts, Director, Health Paul Clifford, Director, Infrastructure Advisory Introduction & Key Findings

    The Evolution
    The (R)evolution

    PwC

    Introduction

    PwC

    About the research


    Findings and estimates are based on: In-depth interviews with global thought leaders and executives from the healthcare and PPP industry Review of literature, reports, and publications An advisory group of 15 professionals from PwCs health industries advisory, tax and assurance practices Economic analysis based on publicly available data sources

    PwC

    The Evolution

    PwC

    Level-setting: PPPs offer a mechanism for governments to finance better healthcare infrastructure and clinical service delivery
    Public-private partnerships (aka, P3, PPP, PFI) establish a contractual partnership between two public and private sector entities where the skills and assets of the private sector are mobilised by the public sector to deliver services and/or infrastructure (e.g., facilities) to the general public. Each one does what it does best in the partnership.
    PPPs can be structured around any or all of the following areas:
    Infrastructure hospitals and clinical facilities Clinical services delivery of medical care, including doctors, nurses, and know-how

    PwC

    In the beginning: Healthcare PPPs started as a way for governments to build new or revamp crumbling infrastructure
    Drivers of Healthcare PPPs
    Investment need Government budget constraints Better procurement Access to skills and knowledge Service capacity
    The fact that infrastructure PPPs were a success gave government confidence that the private sector could deliver. -Peter Coates, Department of Health, England
    PwC

    Examples
    United Kingdom
    Upgraded decaying hospital facilities Surgical service PPPs injected competition into market & improved access Focus is on developing / modernising hospital infrastructure and providing support services
    7

    Australia

    Recently: Healthcare PPPs started to take on a broader scopein response to broader problems
    The sustainability of health systems around the globe is threatened by growing spending and challenging demographic and epidemiological trends. More efficient, value-based models of infrastructure development and care delivery are needed now more than ever.

    PPPs have evolved over time from a primarily infrastructure-oriented model to a clinical services delivery model, increasing in complexity. Some include both.
    Evolution
    Traditional infrastructure based model

    Clinical servicesbased model

    Integrated model combines both infra & clinical service

    PwC

    Metrics to gauge success of PPPs are evolving


    Infrastructure PPPs are measured by:

    PPPs that include clinical services are measured by:


    Operational benchmarks Clinical benchmarks Workforce productivity Patient outcomes Wait times Patient satisfaction

    Value for Money Calculation Estimated cost of the public sector delivering the project ($100 million) (minus) Expected cost of private sector delivering the project ($95 million) Difference in cost ($5 million) Value for money = 5%
    PwC

    The Revolution

    The worlds health systems will, within the next 15 years, find themselves in an unsustainable situation if they do not carry out a number of important changes in their health policies. -Alberto de Rosa Ribera Salud Grupo, Spain

    PwC

    10

    Today: The healthcare PPP revolution as told by numbers


    Spending on health as a % of GDP is growing in all mature and developing economies (includes OECD and
    BRIC nations, see graph below)

    In all cases, growth in health spending outpaces growth in GDP Governments are under pressure to consider new methods of financing and access private sector expertise and efficiency if they want to have any chance of sustaining required investment levels

    PwC

    11

    Sizing the market: Health spending is expected to increase by 65.5% between 2010 and 2020
    As health spending in OECD and BRIC nations grows, so will the need for alternative methods of financing and care delivery PPPs can revolutionise traditional approaches toward cutting costs and improving efficiencies

    PwC

    12

    The more the merrier (and cheaper)


    The more aspects of healthcare that are included in the PPP, i.e., infrastructure + clinical services, the more the potential for savings increases
    Drugs, devices, home, long-term care Primary care

    25-45%

    Estimated cumulative healthcare spending for OECD/BRIC countries, 2010-2020 Healthcare services/products (noninfrastructure) $68.1 trillion

    Potential for savings & efficiency gains

    15-25% 45%
    Hospital - nonclinical services and clinical services

    Infrastructure

    $3.6 trillion

    Infrastructure 2-5%

    *Percent of total health spending


    13

    PwC

    Today: The revolution as told by the PPP players themselves


    Case Study: Independent Sector Treatment Centers, UK Critical roles for PPP players Complexity increases with number of partners, financial terms, definition of value

    Initiative to create competition, reduce wait times and increase workforce


    Includes infrastructure and clinical services for elective surgery (including mobile solutions) NHS pays the hospital operator per procedure undertaken Initially provided volume and income guaranteed to providers (set-up cost) Second wave undertaken at NHS prices Procurement evolved to drive performance for both private and NHS providers
    PwC

    14

    Today: The revolution as told by the PPP players themselves


    Case Study: Health Authority Abu Dhabi Initiative to drive a stepchange improvement in quality of hospital services HAAD contracted with leading international providers for the management of all public hospitals Providers included Cleveland Clinic, Johns Hopkins, Bumrungrad, University of Vienna (VAMED) Limited risk passed to private sector due to lack of reliable historical data 5 7 year contracts with aim to pass more risk to private sector in next round
    PwC 15

    Providers playing key role in design of new facilities

    Key findings the (R)evolution of Healthcare PPPs


    Globally new funding sources need to be identified for healthcare and PPPs are a possible solution.

    PwC has estimated that between 2010 and 2020 spending on healthcare in the OECD and BRIC nations will increase from US$5.3 trillion in 2010 to US$7.94 trillion in 2020.
    Cumulative investment in capital will total US$3.6 trillion over that period. PPPs in healthcare have traditionally been infrastructure projects they are now evolving to include clinical service delivery as well. Success in PPPs is evolving toward health outcomes and performance as well as value for money.

    PwC

    16

    Thank you! Q&A

    CF10397.

    You might also like