Challenges of privatizing academic medical centers in Saudi Arabia and appropriate strategies for implementation Ahmed Al Kuwaiti Department of Dental Education, College of Dentistry and Deanship of Quality and Academic Accreditation, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, and Fahd A. Al Muhanna Nephrology Unit, Department of Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia Abstract Purpose – A crisis in the financial sustainability of the public healthcare sector often compels governments to consider privatization. The purpose of this paper is to summarize various strategies to overcome the challenges facing the privatization of academic medical centers (AMCs) in Saudi Arabia. Design/methodology/approach – In this paper, the authors discuss the challenges faced in privatizing AMCs in delivering their core functions such as patient care, medical education and research. Further, the appropriate strategies are listed to overcome these challenges in privatization of AMCs. Findings – The authors described the benefits of privatization that include a reduction in the financial burden on government healthcare expenditure, quick decision making and creation of new financial models to improve healthcare services. On the other hand, the profit motive of private management could create pressure on patients and may divert AMCs from their primary objectives. Therefore, it is imperative for the government to develop and implement appropriate strategies that balance the benefits of privatizing AMCs with eliminating the negative impact of privatization on patient care, medical education and research. Originality/value – Though AMCs privatization is currently feasible in Saudi Arabia, appropriate strategies are essential to overcome the challenges of its implementation. The government should frame a uniform rules and regulations prior to privatizing public hospitals so that it will fulfill the purpose in an efficient manner. Keywords Organization, Management, Health policy, Clinical governance, Emerging healthcare delivery structures, Health economics, Emerging health economies Paper type Literature review Introduction The term “privatization” is referred to the ownership conversion from public status to either private for-profit or private not-for-profit status (Ko et al., 2014). In recent times, the privatization of healthcare services seek more attention in many countries and is a widespread policy approach used for getting healthcare savings or improving in efficiency, especially in the USA and Europe (Villa and Kane, 2013). In Kingdom of Saudi Arabia (KSA), Ministry of Health (MOH) along with other government sectors provide approximately 80 percent of the healthcare services in the nation, while the private services are mostly covered by the employers of private organizations under the 1999 Compulsory Employment Based Health Insurance (Alkhamis, 2017). Besides, MOH in KSA spent more than 12 trillion Saudi riyals for the healthcare services and direct expenditure on such services accounts for 7 percent of the Kingdom’s budget for the MOH. Saudi Vision 2030 stated that the public sector should emphasis on its planning, regulatory and supervisory roles in healthcare. As a result, MOH intended to privatize 2,259 health centers and 295 hospitals by 2030 (Saudi Gazette, 2016). A main challenge faced by MOH is funding the healthcare services IJHG 25,1 68 The current issue and full text archive of this journal is available on Emerald Insight at: https://www.emerald.com/insight/2059-4631.htm Received 26 June 2019 Revised 15 October 2019 Accepted 2 December 2019 International Journal of Health Governance Vol. 25 No. 1, 2020 pp. 68-77 © Emerald Publishing Limited 2059-4631 DOI 10.1108/IJHG-06-2019-0048