Abstract

This study aims to explore the impact of healthcare digitalization on smart hospital project financing (PF) fostered by pay-for-performance (P4P) incentives. Digital platforms are a technology-enabled business model that facilitates exchanges between interacting agents. They represent a bridging link among disconnected nodes, improving the scalable value of networks. Application to healthcare public–private partnerships (PPPs) is significant due to the consistency of digital platforms with health issues and the complexity of the stakeholder’s interaction. In infrastructural PPPs, public and private players cooperate, usually following PF patterns. This relationship is complemented by digitized supply chains and is increasingly patient-centric. This paper reviews the literature, analyzes some supply chain bottlenecks, addresses solutions concerning the networking effects of platforms to improve PPP interactions, and investigates the cost–benefit analysis of digital health with an empirical case. Whereas diagnostic or infrastructural technology is an expensive investment with long-term payback, leapfrogging digital applications reduce contingent costs. “Digital” savings can be shared by key stakeholders with P4P schemes, incentivizing value co-creation patterns. Efficient sharing may apply network theory to a comprehensive PPP ecosystem where stakeholding nodes are digitally connected. This innovative approach improves stakeholder relationships, which are re-engineered around digital platforms that enhance patient-centered satisfaction and sustainability. Digital technologies are useful even for infectious disease surveillance, like that of the coronavirus pandemic, for supporting massive healthcare intervention, decongesting hospitals, and providing timely big data.

Highlights

  • This study aims to explore the impact of healthcare digitalization on smart hospital project financing (PF) fostered by Pay-for-Performance (P4P) incentives

  • Estimate the potential impact of digital savings on the economic and financial margins of a private special purpose vehicle (SPV); Show how these digital extra-gains can be shared among the key stakeholders with pay-for-performance (P4P) or results-based financing (RBF) contractual schemes

  • To the extent that digital investments are synergic with other innovative devices, they can improve the overall value for money of the investment—a key parameter in project finance selection

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Summary

Introduction

This study aims to explore the impact of healthcare digitalization on smart hospital project financing (PF) fostered by Pay-for-Performance (P4P) incentives. The background is represented by a consolidated trend of aging patients and population growth, which contributes importantly to the rise in healthcare costs. The main drivers for growth in healthcare costs, besides an aging population, are represented by health insurance, and—mainly—technological progress [1]. As Deloitte indicates, financial sustainability, care delivery, patient centricity, digital transformation, and regulatory compliance are at the top of the agenda [2]. Global healthcare expenditure is projected to increase at an annual rate of 5.4 percent between 2017–2022, from USD $7.724 trillion to USD $10.059 trillion [2]. The bulk of health expenditure growth is

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