Cities and Sustainable Technology Transitions
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Cities and Sustainable Technology Transitions

Leadership, Innovation and Adoption

Edited by Marina van Geenhuizen, J. Adam Holbrook and Mozhdeh Taheri

This enlightening book elucidates the leadership challenges of various cities in emerging transitions towards higher levels of sustainability. It examines elements of three socio-technical systems, energy, transport and healthcare, while addressing technology invention, commercialization, mass-production and adoption. The book breaks new ground in the analysis of topical issues such as local ‘cradle’ conditions, incentive schemes, niche-development, living labs, impact bonds, grass-roots intermediation and adaptive policy making. It offers a broad coverage of global systems of cities, with a particular focus on Scandinavia, Germany, the Netherlands, China, Korea, Japan, the US and Canada.
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Chapter 15: Health Impact Bonds as a novel financial arrangement in healthcare transition

Stephan Diek, Marina van Geenhuizen and Bart van Hulst

Abstract

The chapter introduces a novel financial arrangement in healthcare services: Health Impact Bonds (HIBs). Transition aims at making healthcare services not only more affordable but also more efficient, the reason why HIBs focus on the performance (output) side of services (pay-for-success contract). The chapter describes the urgency and challenges in moving towards illness prevention, on the system (healthcare) and project levels. Next, it is explored how HIBs can improve situations of care investment that does not (fully) precipitate at the investor while preventing the rise of new problematic situations. Accordingly, a preliminary list of conditions is designed for the alignment of HIBs. Overall, it seems that HIBs provide substantial solutions by combining new contracts on paying-for-success in performance and a shared savings contract, although some questions remain regarding the involvement of investors. The concluding section includes a reflection on city involvement in HIBs.

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