Lessons from Healthcare PPP’s in India

The NITI Aayog is working to develop and conduct pilot public–private partnership (PPP) projects to improve the delivery of healthcare services. The last two decades saw a rise in discussions and debates on the varied PPP models, as an opportunity to harness the private sector efficiencies and to supplement the public resources. However, the enthusiasm for experimenting with the PPP models fall short of the learnings from it. The limited but growing evidence based on PPPs in healthcare suggests that even the basic tenets of design and implementation of the PPP model have not been met, such as selection of qualified providers\contractors, designing contracts that align incentives, appropriately allocate risks and managing contracts using appropriate performance management tools. In general, the PPP models involve considerable risks and more so in healthcare given its unique characteristics, therefore if not designed and implemented with care, PPP’s in healthcare would prove to be wasteful and burdensome on the public exchequer.