Public-Private Partnerships in Health - Improving Infrastructure and Technology

Contents

List of Figures

List of Tables

Introduction

Chapter 1: Public Private Partnerships and the Quality and Efficiency of Healthcare Services

1.1 Introduction

1.2 Benefits from Public Private Partnerships in the Health Sector

1.3 Sources of Additional Costs

1.4 What Determines the Benefits and Costs?

1.5 Investment Decisions and Affordability

1.6 Conclusion

References

Chapter 2: Choosing the Right PPP Model

2.1 Introduction

2.2 Defining the Main PPP Models

2.2.1 Turnkey Contracts (BF, DBF and BLT)

2.2.2 Operation and Maintenance Contracts

2.2.3 Managed Equipment Service (MES) Contracts

2.2.4 Availability-Based Contracts (DBFMO, DBFM)

2.2.5 Concession Contracts

Bibliography

Chapter 3: The Key Element of PPP: Risk

3.1 Risks in PPP Contracts and the Risk Matrix

3.2 Contract Qualification and Accounting

3.3 Risk and Value for Money

References

Chapter 4: Principles of Capital Budgeting for the Assessment of PPP Projects

4.1 Introduction

4.2 Capital Budgeting Tools

4.2.1 Pro-forma Financial Statements

4.2.1.1 Cash Flow Calculation

4.2.1.2 The Time Distribution and Value of Cash Flows

4.2.2 Profitability Ratios: NPV, IRR and the Appropriate Cost of Capital

4.2.2.1 The Appropriate Cost of Capital

4.2.3 Cover Ratios: DSCR

4.2.4 Sensitivities

4.3 The Economic and Financial Equilibrium in PPP Transactions

4.4 The Renegotiation of the Contract and the Restoration of Economic and Financial Equilibrium

References

Chapter 5: Assessing the Cost of Capital for PPP Contracts

5.1 Introduction

5.2 The Cost of Equity: A Conceptual Framework

5.3 How the Market Really “Thinks”

5.4 Applying the CAPM to PPPs in Real-World Markets

5.4.1 Estimating the Risk-Free Interest Rate

5.4.2 Estimating Beta

5.4.3 Estimating the Equity Market Risk Premium

5.5 Risks in PPP Transactions and Determining the Cost of Equity

5.5.1 Estimating the Cost of Equity, Step by Step

5.6 Conclusion

References