Public-Private Partnership in Healthcare in the Russian Federation: a Story of Success or a Story of Failure?

INTRODUCTION: The need to use tools of public-private partnership (PPP) in the implementation of investment projects is reflected in the national programs and development strategies. Currently, a request has been formed by the state for the implementation of PPP projects in the healthcare sector. Upon that, PPP does not show convincing development dynamics in the sector. AIM: To analyze problems of PPP development in the healthcare sector at the current stage of development in the RF. MATERIALS AND METHODS: Results of qualitative interviews and expert assessments. In the work, qualitative (expert interviews) and quantitative research methods (assessment of expert agreement) were used. RESULTS: According to experts, the key factors limiting development of PPP in the healthcare sector are: a high degree of influence of political leadership on decision making; priority of the state, rather than PPP, order; low estimated profitability of most projects; high bureaucratization of processes; insufficient experience in implementation of projects; low level of competence of officials; high risk of changes in the legal and regulatory framework; integration of projects in the compulsory health insurance system. According to experts, the key drivers of PPP development in the healthcare sector are: extensive and developed legal and regulatory framework; availability of centers for PPP development; a large number of investors; practice of application of PPP tools in different healthcare sectors; existence of negotiation platforms for discussing pressing issues between the state and business. CONCLUSION: The presence of significant limiting factors for the development of PPP in the healthcare sector is an obstacle to an increase in the attractiveness of this sector for investors. The existence of development drivers indicates a generally positive trend in the development of PPP in the healthcare sector. At the same time, ideologization of the sector is necessary with establishing an ‘order’ for the implementation of projects in the sector using PPP tools. Digitalization of processes, a project monitoring system and a more flexible integration of the compulsory health insurance system into the PPP field will increase the investment attractiveness of the state healthcare system.