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A PPP where incentives actually made (some) sense
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Hospital PPPs have a bad reputation. Delays. Overpricing. Rigidity. You’ve heard the stories. I remember when I work at ACS that any RFP announcement of a hospital was received as the last Trump’s tweet… We didn’t know what to do about… Let’s now talk about the Alzira Hospital PPP in Spain. Launched in 1999. First of its kind. A full model: Design. Build. Finance. Operate. Not just the building. Healthcare delivery. High risk. High exposure. High scrutiny. And still… It worked. Well… somehow. Why? 1. Full integration (not half measures) Most PPPs stop at the building. This one didn’t. Same private operator responsible for: Construction + clinical services. No finger-pointing. No “that’s not my contract.” One throat to choke. Risky… but it makes sense. 2. Capitation model (real incentives) The operator got paid per inhabitant. Not per surgery. Not per test. Per person. Keep people healthy → you win. Over-treat → you lose. Some alignment… Finally. 3. Replicated, not reinvented After Alzira, they rolled out the model across Valencia. Same structure. Same logic. Learning curve → real savings. Not “every project is unique.” That’s the excuse of amateurs. Was it perfect? No. Hell NO. And of course… Political cycles killed it years later. But operationally? Efficient. Innovative. Replicable. And that’s the uncomfortable truth again… Most PPP failures are not technical. They’re political. If you want the real playbook about PPPs (not the conference version), you know where to click. ​Mentorship​ When you join... you'll get the course: Breaking Into PPP without the bullshit. PD 1: If you liked this email, don't keep it in secret and forward it to a friend. They will thank you enormously one day. PD 2: If somebody has sent you this email and you want to receive emails like this yourself, visit vicentevalencia.com PD 3: If you want unsubscribe, click the link below. |
Vicente Valencia
I talk about Personal Growth, Management, Infrastructure and More | 👇JOIN +2k readers 👇
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