Despite the growing shift towards procurement centralization among governments around the world, questions remain as to how to increase purchasing within centralized frameworks. While centralized purchasing offers many benefits related to efficiency and quality control, users often prefer more flexible options for purchasing. An unanswered question is how knowledge of user requirements and market trends leads to framework agreements that reduce the inclination for users to purchase goods and services on their own. This study employs healthcare purchasing data from 21 regions in Italy from 2013–2023 to explore how different sources of knowledge about demand and supply affect centralization rates—both in respect to asset-specific and non-asset-specific products. Fixed effects regression results indicate that knowledge of supply gleaned from integrating technical experts into procurement teams enhances centralization for a range of offerings. The influence of demand-related knowledge on centralized purchasing varies by product type, however, with interpersonal exchanges proving more effective for non-asset-specific categories and logistical support mechanisms proving more critical for asset-specific product categories. The results provide longitudinal insights into conditions that are typically studied through cross-sectional data. They also offer important implications for the many countries operating publicly provided health programs, as well as those pursuing broader reforms tied to procurement centralization.

Impact investing is progressively losing focus in ensuring investments really do make a difference; therefore, the growth of the market may not make real social and environmental change. We propose three ways to put the “impact” back into the heart of impact investment.

In the wake of the Covid-19 pandemic, public private partnerships (PPP) can prove useful to close the healthcare investment gap and accelerate long-term recovery, by matching public and private money. Despite their extensive application in the delivery of major infrastructure projects globally, their performance remains contested. Drawing on a unique set of data of PPP contracts for healthcare investments in Italy, the paper explores the antecedents (namely, policies, institutions, and contracts), that have influenced the capacity of PPP contracts to deliver performance, measured in terms of value for money (VfM), and contract stability. Results show that although explicit policy goals have a clear contribution, VfM can benefit from competent central PPP institutions, which should play a hands-on role in the planning, design, and project management activities. At the same time, centralised PPP units, if not combined with local competent authorities and strong governance mechanisms, may increase the risk of contract renegotiation.

The achievement of broad sustainable development policy goals draws more and more on corporate sustainability and financial investment strategies, with renewed hype in the aftermath of Covid-19. Since evermore increasing numbers of market players seem to reject the idea of pure profit maximisation and feel an obligation to contribute to the solution of societal challenges - which they may have contributed to or created in the past with incorrect or ill-judged business practices - they are willing to act as responsible partners and advocate for innovative solutions to create societal (or public) value. This chapter discusses the two main pillars of such renewed approaches: Corporate Social Responsibility and Sustainable Investing, with a specific focus on ESG investing; it further discusses how public sector organisations contribute towards sustainability goals.

This book offers a unique framework to understand how public institutions and private investors can collaborate to sustain long term investments (LTIs), with a specific focus on public-private partnership for infrastructure, blended finance mechanisms, and impact investing.

Over recent years, Impact Investing has attracted increasing capital from global financial institutions, foundations, government agencies, and individuals, simultaneously in the pursuit of social and financial goals. With this unprecedent growth of the market, boundaries between Impact Investing and other overlapping investment approaches are becoming blurred, and concerns are raising regarding whether beyond these capital flows there is real additionality, namely the search for innovative solutions to social and environmental challenges that can generate more impact than existing models. This chapter aims to contribute to the development of the industry by explaining Impact Investing based on its key elements and scope, both from the supply side perspective (the investment approach) and from a demand side perspective (the business models - investees - that embody the co-achievement of financial and societal return); it further discusses how impact management and measurement is central to prove the additionality of impact investing.

Long-term investment is a key contributor to sustainable development, which has started to gain renewed attention after the global financial crisis of 2007-2008, and ever more so in the wake of the Covid-19 pandemic. This chapter discusses the meaning of long-term Investing, the profile and motivations of long-term Investors, and the need of public-private partnerships/collaborations to sustain long-term investments, especially for the achievement of the Sustainable Development Goals (SDGs). SDGs represent an operationalisation of the broad concept of public value, whose realization requires a mobilisation of public and private actors, through a wide array of collaboration models, which can happen at macro, meso and micro levels. The chapter, which serves as an introduction to the whole book, presents two frameworks to understand such collaborations, some of them analysed and discussed in the book.

Blended finance, thanks to its ability to attract private capital towards projects that contribute to sustainable development while providing financial returns to investors, has been increasingly regarded as a tool to reduce inequalities in emerging and frontier markets. In this chapter, we adopt a broader perspective to blended finance, by not just focusing on developing countries. We conceive blended finance as a structuring approach, meant to combine together layers of money coming from different investors, with different profiles, mandates, and expectations, in markets that are affected by some failures or inefficiencies. The chapter describes the key characteristics of blended finance and its instruments, and discusses some cases and applications of blended finance in both developing and mature economies.

Public Private Partnerships (PPP) are under discussion because of the mixed results achieved and the deteriorated trust between public and private actors. However, abandoning PPP could represent a severe mistake in public policy. Based on the recent Italian experience, the authors argue that a new approach to PPP, based on the ESG/SDGs and Impact Investing agenda, could represent an opportunity, both for the public and the private sectors, to contribute to solving wicked problems while generating societal value. This Commentary paves the way for a reflection on this renewed approach to PPP and the need for a new set of skills in the public and private sectors to support the transition.

Infrastructure is one of the most relevant long-term investments and it is crucial for the achievement of SDGs. Therefore, it represents a vehicle for public value generation. Infrastructure is, in the majority of cases, a public asset, where private players can play a fundamental role, both through public procurement and public-private partnerships (contractual or institutional). The involvement of private investors (industrial and financial) is crucial for mobilizing the capital needed to close the infrastructure gap but also to generate more innovation, sustainability, and quality across the infrastructure lifecycle. The chapter discusses these topics with a specific focus on the different delivery models to build and/or operate a greenfield/brownfield infrastructure and the different financial schemes to mobilize private capital in infrastructure. The chapter clarifies that despite the different "labels" and policies in place to mobilize private investors in infrastructure, there are some fundamental schemes which should be known by all the stakeholder to take more informed but also unbiased decisions.

In risky public-private partnership (PPP) projects, governments and public institutions tend to offer private investors certain guarantees for their participation. However, when public sector capacity and institutions are weak, these guarantees can generate moral hazard in the bidding process and lead to contractual renegotiations, resulting in a loss for taxpayers. Drawing on a sophisticated, agent-based model that recreates the complex dynamics of the PPP procurement process, this paper demonstrates public sector competency is crucial for limiting moral hazard when guarantees are offered in PPP projects.

One of the most powerful ways to attract private capital in infrastructure is the contractual public private partnership model, also known as PPP. The chapter outlines the fundamental features of such contracts (among others, payment mechanisms and risks allocation), both for economic and social infrastructure, with a specific focus on the two dominant models (the tariff-based and the availability-based models). It discusses the main macroeconomic and microeconomic benefits of PPPs, and it suggests how to apply PPP in a more strategic way in order to generate value for society. The chapter also provides a focus on the application of PPP to social infrastructure, and in particular in the healthcare sector, where the model has been questioned, making it is salient to understand how to structure more balanced contracts in sectors that are critical to achieve SDGs.

Social impact bonds (SIBs) have emerged in recent years as outcome-based public-private partnerships (PPP) for the delivery of welfare services, whereby economic operators’ remuneration is based on their capacity to achieve service outcomes, thus improving contracting authorities’ ability to tackle specific social needs. Despite the different nuances, this chapter discusses whether SIBs can be regarded as a first step to testing the feasibility of linking the investors’ payment to outcomes and, therefore, as a scheme that could be extended to traditional infrastructure-based PPP contracts.