Negative competition steering patient flow in a public-private healthcare co-opetition setting – a Finnish case

Abstract

Healthcare services are produced jointly by public and private service providers. Simultaneously they are each others’ competitors, thus operating in a co-opetition setting. Co-operation enables producing healthcare services efficiently. However, the public service providers have to operate on budget funds providing services to everyone, while private service providers skim the shared patient flow to make their own processes leaner and remunerative. Because both public and private service providers want to get the most profitable and medically interesting cases they all try to offload the low-ranking and non-profitable cases to other service providers’ patient queues. This phenomenon is called negative competition. The paper investigates how a public-private co-opetition setting steers the patient flow and changes the production of healthcare services. The paper is based on a comprehensive case study conducted in a healthcare co-opetition network. The outcome is an analysis on how producing healthcare services by a public-private c-oopetition setting affects the efficiency and productivity of the healthcare system.