Asset management firms are characterized by having quite high margins, although working in a highly competitive industry. However, the nature of their businesses makes it difficult to define both debt and reinvestment, making the estimation of cash flows much more difficult. It is reasonable to assume that Free Cash Flows to Equity-holders (FCFE) are proxied by net earnings because of a negligible level of investments, depreciation, and net working capital. For Asset Management firms, dividends are often the only tangible cash flow that we can observe or estimate. The common methods used to value asset management firms are the discounted cash flow, the multiples, and the Dividend Discount Model, with some adaptions. Despite their simplicity, rules of thumbs are often characterized by the inaccuracy of the final value.
This study aims to explore the impact of healthcare digitalization on smart hospital project financing (PF) fostered by pay-for-performance (P4P) incentives. Digital platforms are a technology-enabled business model that facilitates exchanges between interacting agents. They represent a bridging link among disconnected nodes, improving the scalable value of networks. Application to healthcare public–private partnerships (PPPs) is significant due to the consistency of digital platforms with health issues and the complexity of the stakeholder’s interaction. In infrastructural PPPs, public and private players cooperate, usually following PF patterns. This relationship is complemented by digitized supply chains and is increasingly patient-centric.
L’innovazione tecnologica in ambito sanitario sta trasformando i processi di cura e modificando il perimetro d’investimento delle infrastrutture sanitarie che intendono puntare a una sanità di maggiore qualità e più sostenibile. I modelli di business diventano più complessi e interdipendenti, con nuove leve di creazione di valore che devono essere interpretate, come la capacità di generare flussi di cassa (cash is king), anche a servizio del debito. Occorre verificare la bancabilità degli investimenti tecnologici in sanità cercando di combinare le esigenze degli investitori pubblici e privati con quelle degli istituti finanziatori, nell’ambito di nuove operazioni di Partenariato Pubblico Privato. Per la banca, a fronte di maggiori rischi operativi e tecnologici, servono nuovi processi di Risk management, nella prospettiva di rendimenti superiori legati al Result-based Financing, da valutare ai fini della bancabilità.
This study aims to detect if and how big data can improve the quality and timeliness of information in infrastructural healthcare Project Finance (PF) investments,making themmore sustainable, and increasing their overall efficiency. Interactions with telemedicine or disease management and prediction are promising but are still underexploited. However, given rising health expenditure and shrinking budgets, data-driven cost-cutting is inevitably required. An interdisciplinary approach combines complementary aspects concerning big data, healthcare information technology, and PF investments. The methodology is based on a business plan of a standard healthcare Public-Private Partnership (PPP) investment, compared with a big data-driven business model that incorporates predictive analytics in different scenarios. When Public and Private Partners interact through networking big data and interoperable databases, they boost value co-creation, improving Value for Money and reducing risk. Big data can also help by shortening supply chain steps, expanding economic marginality and easing the sustainable planning of smart healthcare investments. Flexibility, driven by timely big data feedbacks, contributes to reducing the intrinsic rigidity of long-termed PF healthcare investments.
This paper explores innovative governance models in the healthcare sector. Patients are a key albeit under-investigated stakeholder and smart technologies applied to public healthcare represent a trendy innovation that reshapes the value-driving proposition. This study contributes to the best practice improvement in this sector, showing how health governance can balance the interests of conflicting stakeholders (patients, staff, politicians, private providers, banks, suppliers, etc.) when technology-driven (smart) investments are realized. Characteristics of smart hospitals are critically examined, and governance solutions are considered, together with private actors’ involvement and flexible forms of remuneration. Smart hospitals are so complicated that they may require sophisticated Public-Private Partnerships (PPP). Public players lack innovative skills, whereas private actors seek additional remuneration for their non-routine efforts and higher risk. PPP represents a feasible governance framework, especially if linked to Project Financing (PF) investment patterns. Results-Based Financing (RBF) softens traditional PPP criticalities as availability payment sustainability or risk transfer compensation. Waste of public money can consequently be reduced, and private bankability improved. Patient-centered smart hospitals reshape traditional healthcare governance, with savings and efficiency gains that meliorate timeliness and execution of cares. Transformation of in-patients to out-patients and then home-patients represents, whenever possible, a mighty goal.
This article addresses the relationship between Public-Private Partnerships (PPP) and the sustainability of public spending in smart hospitals. Smart (technological) hospitals represent long-termed investments where public and private players interact with banking institutions and eventually patients, to satisfy a core welfare need. Characteristics of smart hospitals are critically examined, together with private actors’ involvement and flexible forms of remuneration. Technology-driven smart hospitals are so complicated that they may require sophisticated PPP. Public players lack innovative skills, whereas private actors seek additional compensation for their non-routine efforts and higher risk. PPP represents a feasible framework, especially if linked to Project Financing (PF) investment patterns. Whereas the social impact of healthcare investments seems evident, their financial coverage raises growing concern in a capital rationing context where shrinking public resources must cope with the growing needs of chronic elder patients. Results-Based Financing (RBF) is a pay-by-result methodology that softens traditional PPP criticalities as availability payment sustainability or risk transfer compensation. Waste of public money can consequently be reduced, and private bankability improved. In this study, we examine why and how advanced Information Technology (IT) solutions implemented in “Smart Hospitals” should produce a positive social impact by increasing at the same time health sustainability and quality of care. Patient-centered smart hospitals realized through PPP schemes, reshape traditional healthcare supply chains with savings and efficiency gains that improve timeliness and execution of care.
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