Health Care and the Implementation of Public–Private Partnership (PPP) Instruments in Transition Balkan Countries

The Public–Private Partnership (PPP) phenomenon is enjoying a global revival of popularity, despite much uncertainty on the definitions of partnership and the colorful experience gained from their practical application. While they are being rapidly embraced not only in the free market and developed economies but also in developing countries, uncertainties persist as to what exactly is innovative—or fruitful—about PPP. In developed countries, the evolution of PPP to “state after welfare”, reflects a shared experience in systems theory that has evolved substantially, particularly in Western European economies. This article analyzes the dynamics of implementation of PPP in the healthcare sector considered as opportunities for countries in transition, enhancing the case of Albania considered as a typical Balkan transition country of the post-Soviet era. When the course of two decades has almost been completed the changes that countries in transition are facing are significant and have transformed the way of the economic environment. In transitioning or developing economies, despite the potential for PPP arrangements to finance and develop public projects, the use of PPPs has been slow and limited (Yang et al., Public Administration Review 73:301–310, 2013). Currently, Albania boasts a portfolio of more than 222 PPP, 186 in energy with the rest in transport, health, environment, and agriculture. As in the focus of the article, there is an overview of the four PPP in the healthcare sector considering one out of four as the case study based on the importance as well as the changes and needs during Covid-19. The article will highlight a need to adopt a long-term strategy in the field of healthcare as well as applicable standards for the monitoring of the implementation procedures. The healthcare sector in a typical Balkanic transition country, that aspires for European Union membership, such as Albania, was considered as a case study in the research because in the healthcare were introduced reforms aim to improve the public health system, the quality of care provided, and to reduce out-of-pocket healthcare expenses and the application of PPP in this sector were considered as part of this reforms and their success. The case study is based on the data collected from the analysis of the contracts signed between the parties, different reports, interviews and the documentation collection with regard to the management of this contract are going to be used. During the Pandemic moment, the implementation of these contracts became even more important for a country facing a global emergency regarding health care when these contracts were seen as a way of innovation in the management of public services.