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5 Days

September 23 – 27, 2019

Price: 4,300 EUR

Price includes full board accommodation. Group discount of 10 % in case of two or more participants per company and date. Early bird discount of 10 % in case of registration three months before (only one discount may be used).             

Public-Private Partnerships in the Health Care Sector will be recognized as the in-class Week of Certified Expert in Business Development programme.

Target group

The course is aimed specifically at key public decision-makers and managers of healthcare PPPs also including oversight agencies and private operators, as well as officials from development agencies supporting PPP approaches.

Learning target

With Public Private Partnerships in the Health Sector participants will learn and discuss:

  • How PPPs may fit into the broader health system of a country
  • What type of services may be offered as a PPP and how to select projects
  • How to design specific PPPs with emphasis on performance requirements and related payment and incentive schemes
  • How to go about drafting contracts, awarding contracts through competitive processes and how to approach project finance
  • How to supervise and manage PPP contracts after the award including dealing with contract modification, disputes and termination

Participants will also discuss the potential downside of PPPs using case studies of hotly debated PPPs. Participants from developing economies are encouraged to “bring their own PPP” to the course and will receive feedback on their burning issues from faculty members as well as professional colleagues from other countries and agencies.

Agenda | September 23-27, 2019

Monday, September 23th - Context for and Role of PPPs

09:00 – 10:30

Session 1: Introduction

Learning Objectives: Get to know fellow participants and faculty and a sense of health PPP issues faced by participants in their home country. Understand that the course design itself reflects a principled approach to the development of PPPs and how the week will develop based on this.

11:00 – 12:30 

Session 2: Healthcare Systems in Transition

Learning Objectives: Review “burden of disease” shifts in emerging markets. Understand the basic building blocks of healthcare systems including payment schemes, regulatory approaches and types of provision. Obtain an overview of the basic healthcare systems in the world i.e. the way, in which the basic building blocks have been combined. Understand what we know (and do not know) about the link between healthcare system design and health outcomes as well as the resulting debates about healthcare reform. Understand key issues in moving from discussion of strategies to institutional reform. Appreciate different approaches to ownership of providers and customer choice and thus the basic setting for PPPs.

13:30 – 15:00 

Session 3: PPP – Why Bother?

Learning Objectives: Obtain an overview of healthcare PPP activity globally with special emphasis on PPPs in countries of course participants. Know the arguments about what a PPP may or may not be and appreciate the continuum of solutions from public to private solutions. Understand the basic rationales for PPPs in healthcare as well as key criticisms and pitfalls. Appreciate the current state of knowledge of evaluation of the outcomes and impacts of health PPPs.

15:30 – 17:00 

Session 4: Selected PPP Cases from Different Markets

Learning objectives:  Obtain an overview of key contract features in health care PPPs in emerging markets as well as variations in contractual arrangements. Appreciate key issues and trade-offs in contract design. Discussion among participants to highlight the issues they face or have faced in their own PPPs.

Tuesday, September 24th - Regulation / Contract Design: Performance and Incentives

09:00 – 10:30  

Session 5: The PPP “Lego  Set”

Learning Objectives: Understand ways in which PPPs can be composed on a continuum from simple service contracts to all encompassing investment and operating responsibilities for private partners.  Appreciate the fundamental policy choices

about market structures in which PPPs operate ranging from free competition regimes to state-planned systems with selective tendering for PPPs. Review the core legal frameworks for PPPs and selected political challenges

11:00 – 12:30 

Session 6: Quality  and Performance

Learning Objectives: Appreciate the existing types of measurement options for the performance of healthcare schemes ranging from input measures incl. process quality via cost measures to outcome and performance measures including cost- effectiveness. Obtain an overview of related benchmarking approaches. Discuss performance measurement schemes of PPP cases.

13:30 – 15:00 

Session 7: Payments, Risks and Incentives

Learning Objectives: Appreciate the options for tying payment schemes to performance (e.g. availability, cost, volume, quality) and the resulting allocation of risks and incentives as well as the consequent measurement and monitoring challenges. Understand differences and similarities between for-profit and non-profit firms whether private or state-owned. Discuss incentive schemes pf PPP cases.

15:30 – 17:00 

Session 8: Workshop

Case discussion on PPP objectives, quality and performance measurement as well as monitoring systems.

Wednesday, September 25th - Choosing Wisely

09:00 – 10:30  

Session 9: Project Selection

Learning Objectives: Appreciate the centrality of project selection. Understand the how to assess demand and commercial viability / affordability. Appreciate how to assess commitment i.e. the likelihood that the contracting parties will honour commitments and deal sensibly and fairly with each other for the duration of the PPP.

11:00 – 12:30 

Session 10: Designing Contracts

Learning Objectives: Understand the basic elements of a PPP contract. Appreciate the role of lawyers in the PPP process. Emphasis will be on coping with inevitable changes and things that go wrong (e.g. adjustments, change orders, dispute resolution, termination).

13:30 – 15:00 

Session 11: Project Finance

Learning Objectives: Understand the typical structuring options in health PPPs including allocation of risks to counterparts that render a deal bankable on a “non-recourse basis”. Appreciate the central role of creditor concerns and the analysis of risk by creditors. Obtain an understanding of key issues in project finance deals for health PPPs.

15:30 – 17:00 

Session 12: Workshop

Case discussion on PPP contracting and financing as well as considering changes.

Thursday, September 26th - Getting to Closure

09:00 – 10:30  

Session 13: Project Finance:  Public  versus  Private Money?

Learning Objectives: Discuss the fundamental questions about calculation methods and interest rates for different financing models and options in health PPPs including allocation of risks. Discuss key issues in project finance deals for health PPPs. Understand what is involved in assessing “value for money” from the point of view of society and fiscal impact

11:00 – 12:30 

Session 14: Special Contracting Issues

Learning Objectives: Appreciate the ongoing issues that arise when operating a PPP and the implications for contract design and oversight.  Understand the skills required by the contracting partners to achieve sound co-operation, including the type of advisers that may usefully support the contracting parties. Understand the fundamental market entry options for private healthcare providers.

13:30 – 15:00 

Session 15: Market  Entry  and Contract Award

Learning Objectives: Understand options for PPP procurement strategies and the pros and cons of different approaches (e.g. pre-qualification, choice of award parameters, and reliance on bidding or negotiation, dealing with unsolicited bids). Appreciate what is involved in marketing a PPP and in managing the bid process including the steps from contract award to financial closure.

15:30 – 17:00 

Session 16: Workshop (break-out groups)

Learning Objectives: Develop issues and options for dealing with selected participants’ cases that are currently under consideration in their home country.

Friday, September 27th - Managing PPPs

09:00 – 10:30  

Session 17: (Virtual) Site Visit:  Hospital PPP Project

We will “visit” an ongoing hospital PPP project in Germany. The contract manager of the PPP will introduce the project and will describe the approach taken. Of key interest is the approach to performance specification and the resulting planning and contracting approach. Participants will also be able to discuss the issue of effective risk transfer, which arises under several German PPPs.


11:00 – 12:30 

Session 18: Controversies around PPP

Learning Objectives: Based on a case analysis of the Alzira hospital PPP in Spain develop a list of controversial issues that may arise under health PPPs. Understand how to assess whether criticism is legitimate or not and what useful responses might be.


13:30 – 15:00 

Session 19: PPP Oversight – Lessons Learned

Learning Objectives: Understand what policy and legal framework issues need to be clarified, how government can organize itself to deal with PPPs from project selection to implementation supervision and the management of fiscal implications.

 15:30 – 16:30 

Session 20: Participant Feedback and Certificates Handover


Prof. Dr. Afschin  Gandjour

works as a Professor of Health Management at Frankfurt School of Finance and Management in Germany. He is a medical doctor, health economist, and philosopher and ranks among the top 5 researchers in business administration in Germany (ranking by the newspaper Handelsblatt from September 2012). Gandjour serves on the editorial boards of Applied Health Economics & Health Policy, The Open Health Services & Policy Journal, and Innovation and Entrepreneurship in Health. He received an M.D. from Hannover Medical School in Germany, an M.B.A. from Duke University, a Ph.D. in health economics from the University of Cologne in Germany, and an M.A. in philosophy from the University of Düsseldorf in Germany. He held faculty positions at the University of Cologne Medical School, Baylor College of Medicine, and Louisiana State University Pennington.

Prof. Dr. Michael Klein

is Professor at the Frankfurt School of Finance & Management in Germany and a Senior Adjunct Professor at the Johns Hopkins School of Advanced International Studies in Washington D.C.
Michael worked at the World Bank (1982 – 2009), most recently as Vice President for Financial and Private Sector Development for the World Bank Group as well as Chief Economist, International Finance Corporation. He was Chief Economist of the Royal Dutch / Shell Group (1997 – 2000) and headed the unit for non-OECD economies at the OECD Economics Department (1991 – 1993). Before joining the World Bank, Michael was active in Amnesty International and served on its German Board (1977 – 1979) and International Executive Committee (1979 – 1982).
Michael studied in Bonn, New Haven and Paris and received his doctorate in economics from Bonn University, Germany.

Prof. Dr. Rainer Sibbel

has held the Chair for International Health Management at the Frankfurt School of Finance & Management since 2004. He is the Academic Director of the MBA – International Healthcare Management programme and head of the Institute for International Health Management. From 1987 to 1993, studies of mathematics at Westfälische Wilhelms-Universität  Münster, Germany. Subsequently, from 1993 to 1999, research assistant at the Institute of Industrial and Health Care Management, University of Münster, Germany. In 1997, awarded a degree as Doctor of Business Administration. From 1999 to 2004, postdoctoral research assistant at the Chair for Operations Management, University of Bayreuth, Germany. January 2004, Habilitation (qualification for rank as professor; topic: Capacity Planning and Organisation for Interactive Services in Hospitals). In March 2004, visiting professor at Shanghai International Studies University. Prof Sibbel is Member of the German Academic Association for Business Research, the Association for Operations Research (GOR), the International Health Economics Association and the International Hospital Federation (IHF). He has published extensively on healthcare and hospital management, privatization and performance management in the healthcare sector.

Paul Da Rita

is an experienced PPP practitioner who has worked with many public and private sector organisations in delivering innovative and complex healthcare PPP projects across the world, over the last 20+ years. After many years in Corporate roles, Paul decided to set up on his own to better allow him to focus on the two areas of work that he has a real passion for – Health PPPs and Emerging Markets. Previously, Paul led IFC’s Global Health and Education PPP Advisory business, which provides advice to many governments in emerging countries on structuring and delivering PPP projects. Prior to arriving at IFC in June 2013, he was the Global Leader for health PPPs for PwC. Paul was also a senior member of PwC’s Corporate Finance healthcare team in the UK having joined in September 2000. During that time he completed a number of high profile and complex deals from the largest UK Healthcare project at Barts and The Royal London, to the largest international project for the New Karolinska Hospital in Stockholm.


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