The Bahia State Government got into agreements with private companies for the management of emerging public hospitals that were built and funded by the government. The main objective of the government is to improve the efficiency of operations, elevate the quality of services and undertake a shift of operational risks.
The private operators acquire new employees and manage the facilities (among them medical services) in contracts that are funded on a yearly basis and goes for up to five years. The operators are required to attend to all of the patients that visit the health center. The government, on the other hand, is required to pay for the medical services with regard to the projected size of patients that visit the center. The operators have to acquire about 80 percent of projected number for payment to made, though they are not reimbursed for targets that are exceeded. However, most of these them are exceeded by about 30 percent.
Critical Issues
Taking into consideration that public and private partnership to be vital in the improvement of quality of care and management of cost, governments have to be aware of the vital issues:
Universal Access: so as to make sure every person has access to sufficient hospital care, some contracts require the provider to go on offering service to all public patients. The provider may at times be compensated by the government, though at times may he accepts the financial threat on assumption that it will lead to cross-subsidies from the patients and financing bodies.
Funding: Governments in most cases finance public health centers using budgetary payments or insurance schemes. Not long ago, governments have moved from input costs to clinical mix of patients to be handled. With a change to private management, added focus has been allocated to connecting the public funding (be it from budget or public insurance) to performance while similarly appreciating the quality of care and patient comfort.
Consolidation: Most countries have several public hospitals and will have to trim, consolidate and shut down certain facilities. The partnership formed by private and public companies can lead to consolidation of services. Governments can tender certain facilities, making it possible for private companies to consolidate them while still offering some form of clinical services.
Competitions: rivalry between hospitals leads to quality and efficiency of operations. Governments ought to resist granting privately managed public hospitals special privileges. Similarly, where the government has some form of interest, there should be no discrimination to other hospitals.
Regulation: In most countries, the regulatory models applied in hospitals is restricted to certain agencies that undertakes accreditation. However, the public and private partnership may lead to additional obligations that call for monitoring, sanctions and dispute resolution processes. This may call for the government to step in. Additionally, the government will have to focus on the extent to which they depend on regulation, legislation and certification or arrangements organized with the private providers. The experience on privatization process may mean that an independent regulator is required to monitor and impose public-private partnership contrast for health centers.
