Governments and their health care systems or operators are increasingly looking for improved, economically viable and more robust delivery of health care services. This has generated a real opportunity for entities that can provide these services to fulfil their needs.

Global health  care  entities,  health care operators and governments are increasingly entering into cross-border joint  ventures and affiliation models to gain access to best practice in an effort to better deliver health care services. Typically, the parties to such an arrangement are

  • Major health care entities, such as a health care system, academic medical institution or leading hospital (referred to here for simplicity as the "international body").
  • A national government, local health authority or health care operator, (referred to here as the "delivery body").

From both sides, there are a number of issues the parties should take into account when structuring a collaboration to ensure each party achieves its aims and objectives. Equally, there are a number of common pitf alls that should be avoided.

INITIAL DUE DILIGENCE

There is no substitute for being properly prepared and undertaking a thorough due diligence exercise to ascertain where the opportunities are and to mitigate any risks that may arise.

Actions that should be completed at this initial stage include the following:

  • A full investigation by each part y into the other's capability, validity and ability to perform.
  • A thorough financial analysis that includes  ensuring  both  parties under stand, in particular, the local reimbursement policy and determining whether or not this creates a sustainable business model going forward.
  • A detailed counterparty and competitor analysis to evaluate who else is active in the local jurisdiction and whether or not the joint venture or collaboration can realistically create a market  leading  or sustainable position.
  • A comprehensive review of both parties' governance and compliance policies and an assessment of the local jurisdiction's political, financial and cultural landscape. Issues that should be considered include determining whether or not both parties have a standard of compliance with local and international anti­ corruption and anti-bribery legislation.

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