The Use of Payment by Results in Healthcare: A Review and Proposal

  • Alessandro RizzelloEmail author
  • Rossana Caridà
  • Annarita Trotta
  • Giuseppe Ferraro
  • Rosella Carè
Part of the Palgrave Studies in Impact Finance book series (SIF)


In recent decades, governments worldwide have begun to extend the use of Payment by Results (PbR) contracts. PbR contracts create a new type of partnership between investors, governments and service providers that engages them in a new way through complex outcome-based financial arrangements. In Italy, the diffusion of such instruments is limited by market and by legal barriers. Based on these considerations, our work aims to present an overview of the literature on PbR models, with Social Impact Bonds (SIBs) as the main subject, and to perform an explorative analysis of multiple case studies (focusing on innovative SIBs in healthcare) of such schemes.

 The study contributes to the international debate by offering several insights and implications for scholars, practitioners and policy makers. In addition, it aims to help clarify—from a law and economic perspective—the opportunities and obstacles related to the development of PbR instruments in the Italian context.


Impact investing Payment by results Social impact bond Healthcare 


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Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Alessandro Rizzello
    • 1
    Email author
  • Rossana Caridà
    • 1
  • Annarita Trotta
    • 1
  • Giuseppe Ferraro
    • 1
  • Rosella Carè
    • 1
  1. 1.University Magna Graecia of CatanzaroCatanzaroItaly

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