Profitability analysis of public-private partnership in healthcare delivery in Spain

Abstract

In the Valencian Community (Spain) there are 5 health districts managed by public-private partnerships. They are the so-called Alzira model, where the concessionaire builds and maintains the hospital facilities and provides health care services. The purpose of this paper is to address problems raised in the calculation of the limiting clause of profitability and to develop a financial statement analysis in order to assess profitability, solvency and liquidity. Results indicate that all concessionaires show very high debt-to-assets ratio, low liquidity, ROA fluctuates between 2.45% and 12.42%, and the IRR varies between 3.47% and 13.15%. Despite this, four of five concessionaries exceed the limiting clause using an “ad hoc” method as proxy of “cash flows”.