|
Contents |
6 |
|
|
List of Figures |
7 |
|
|
List of Tables |
8 |
|
|
Introduction |
9 |
|
|
Chapter 1: Public Private Partnerships and the Quality and Efficiency of Healthcare Services |
11 |
|
|
1.1 Introduction |
12 |
|
|
1.2 Benefits from Public Private Partnerships in the Health Sector |
12 |
|
|
1.3 Sources of Additional Costs |
14 |
|
|
1.4 What Determines the Benefits and Costs? |
16 |
|
|
1.5 Investment Decisions and Affordability |
17 |
|
|
1.6 Conclusion |
19 |
|
|
References |
21 |
|
|
Chapter 2: Choosing the Right PPP Model |
24 |
|
|
2.1 Introduction |
25 |
|
|
2.2 Defining the Main PPP Models |
26 |
|
|
2.2.1 Turnkey Contracts (BF, DBF and BLT) |
29 |
|
|
2.2.2 Operation and Maintenance Contracts |
31 |
|
|
2.2.3 Managed Equipment Service (MES) Contracts |
32 |
|
|
2.2.4 Availability-Based Contracts (DBFMO, DBFM) |
38 |
|
|
2.2.5 Concession Contracts |
45 |
|
|
Bibliography |
50 |
|
|
Chapter 3: The Key Element of PPP: Risk |
52 |
|
|
3.1 Risks in PPP Contracts and the Risk Matrix |
53 |
|
|
3.2 Contract Qualification and Accounting |
61 |
|
|
3.3 Risk and Value for Money |
65 |
|
|
References |
72 |
|
|
Chapter 4: Principles of Capital Budgeting for the Assessment of PPP Projects |
74 |
|
|
4.1 Introduction |
75 |
|
|
4.2 Capital Budgeting Tools |
76 |
|
|
4.2.1 Pro-forma Financial Statements |
77 |
|
|
4.2.1.1 Cash Flow Calculation |
78 |
|
|
4.2.1.2 The Time Distribution and Value of Cash Flows |
82 |
|
|
4.2.2 Profitability Ratios: NPV, IRR and the Appropriate Cost of Capital |
82 |
|
|
4.2.2.1 The Appropriate Cost of Capital |
85 |
|
|
4.2.3 Cover Ratios: DSCR |
87 |
|
|
4.2.4 Sensitivities |
88 |
|
|
4.3 The Economic and Financial Equilibrium in PPP Transactions |
90 |
|
|
4.4 The Renegotiation of the Contract and the Restoration of Economic and Financial Equilibrium |
91 |
|
|
References |
93 |
|
|
Chapter 5: Assessing the Cost of Capital for PPP Contracts |
94 |
|
|
5.1 Introduction |
95 |
|
|
5.2 The Cost of Equity: A Conceptual Framework |
95 |
|
|
5.3 How the Market Really “Thinks” |
99 |
|
|
5.4 Applying the CAPM to PPPs in Real-World Markets |
100 |
|
|
5.4.1 Estimating the Risk-Free Interest Rate |
101 |
|
|
5.4.2 Estimating Beta |
102 |
|
|
5.4.3 Estimating the Equity Market Risk Premium |
105 |
|
|
5.5 Risks in PPP Transactions and Determining the Cost of Equity |
109 |
|
|
5.5.1 Estimating the Cost of Equity, Step by Step |
110 |
|
|
5.6 Conclusion |
115 |
|
|
References |
117 |
|