Good Practices in Health Care “Management Experimentation Models”: Insights from an International Public Private Partnership on Transplantation and Advanced Specialized Therapies

The research analyzes good practices in healthcare “management experimentation models”, which fall within the broader range of the public-private integrative partnerships (PPPs). Particularly, the study refers to the international collaboration started in 1997 between the Italian “Civico” and “Cervello” hospitals and the University of Pittsburgh Medical Center (UPMC- Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies. Introduced by the Italian National Healthcare System in 1991, the “management experimentation models” are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality and cost-savings. The long-term collaboration is characterized by a process of authorization, monitoring and a long period of experimentation that can be concluded with the stabilization of the partnership or the exit of public institutions from it. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity and equity of access, but requires higher financial responsibility for the managers and more flexibility in the operations. In Italy the experience of such experimental models is limited but successful. The recognition of ISMETT’s good management practices, one of the first Italian medical center in the form of a limited liability company with an international partner, is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting.