5 hospitals with strong finances

http://www.beckershospitalreview.com/finance/5-hospitals-with-strong-finances-080117.html

Here are five hospitals and health systems with strong operational metrics and solid financial positions according to recent reports from Fitch Ratings, Moody’s Investors Service and S&P Global Ratings.

Note: This is not an exhaustive list. Hospital and health system names were compiled from recent credit rating reports and are listed in alphabetical order.

1. Coral Gables-based Baptist Health South Florida has an “AA-” rating and stable outlook with S&P. The system maintained key balance sheet metrics and generated better-than-projected financial results in fiscal year 2016, according to S&P.

2. Carolinas HealthCare System has an “Aa3” rating and stable outlook with Moody’s. The Charlotte, N.C.-based system has a track record of good financial performance, strong balance sheet metrics and a large scope of operations with multiple hospitals. Moody’s expects Carolinas HealthCare System to maintain stable leverage metrics while continuing to generate financial results at current levels.

3. Children’s Healthcare of Atlanta has an “Aa2” rating and stable outlook with Moody’s. CHOA is a leading provider of high acuity pediatric care in the Atlanta area and has favorable leverage metrics and a track record of strong margins and liquidity, according to Moody’s.

4. Cleveland Clinic Health System has an “Aa2” rating and stable outlook with Moody’s. The system has a track record of meeting operating challenges to sustain strong cash flow, exceptional fundraising capabilities, strong liquidity and a growing ability to leverage an international brand into revenue diversification, according to Moody’s. The debt rating agency expects Cleveland Clinic to manage execution risks of multiple strategies, as demonstrated in the past.

5. Broomfield, Colo.-based SCL Health has an “AA-” rating and stable outlook with Fitch. The system’s operating performance improved in fiscal year 2015, and SCL has sustained those results, according to Fitch. The system has manageable capital needs in the near term, a stable liquidity position and geographic diversity, with 12 hospitals in five markets across three states.

 

9 recent hospital, health system outlook and credit rating actions

http://www.beckershospitalreview.com/finance/9-recent-hospital-health-system-outlook-and-credit-rating-actions.html

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The following hospital and health system credit rating and outlook changes and affirmations took place in the last week, beginning with the most recent.

1. Fitch assigns ‘A+’ rating to Regional Health’s bonds
Fitch Ratings assigned an “A+” rating to Rapid City, S.D.-based Regional Health’s proposed $214.4 million series 2017 revenue bonds to be issued by the South Dakota Health & Educational Facilities Authority.

2. Moody’s downgrades Midland County Hospital District’s debt rating to ‘Aa3’
Moody’s Investors Service downgraded Midland (Texas) County Hospital District’s general obligation debt rating to “Aa3” from “Aa2,” affecting $101.1 million of general obligation debt.

3. Moody’s assigns ‘Baa3’ rating to SoutheastHealth’s bonds
Moody’s Investors Service assigned its “Baa3” rating to Cape Girardeau, Mo.-based SoutheastHealth’s proposed $86.9 million series 2017A and $6.29 million series 2017B revenue bonds, to be issued through the Industrial Development Authority of the County of Cape Girardeau and the Industrial Development Authority of Stoddard County. The bonds will mature in 2042.

4. Moody’s affirms ‘A1’ rating on Sarasota County Public Hospital District’s bonds
Moody’s Investors Service affirmed its “A1” rating on Sarasota (Fla.) County Public Hospital District’s outstanding bonds, affecting $192 million of debt.

5. S&P revises NorthShore University HealthSystem’s outlook to stable
S&P Global Ratings affirmed the “AA” rating on Evanston, Ill.-based NorthShore University HealthSystem’s series 2010 revenue refunding bonds, issued by the Illinois Finance Authority.

6. S&P upgrades HealthEast Care System’s bond rating to ‘A+’
S&P Global Ratings upgraded the rating to “A+” from “BBB+” on St. Paul, Minn.-based HealthEast Care System’s series 2017A bonds, issued by the Redevelopment Authority of the City of Saint Paul.

7. Moody’s assigns ‘A2′ rating to Fairview Health Services’ bonds
Moody’s Investors Service assigned its “A2” rating to Minneapolis-based Fairview Health Services proposed $197 million series 2017A revenue bonds to be issued through the Housing and Redevelopment Authority of the City of St. Paul, Minn. The bonds will be fixed rate and will mature in 2047.

8. Moody’s assigns ‘A3’ rating to North Valley Hospital’s bonds
Moody’s Investors Service assigned its “A3” to Tonasket, Wash.-based North Valley Hospital’s proposed $8.5 million unlimited tax general obligation refunding bonds. The expected sale date is Aug. 16.

9. Moody’s downgrades Lucile Packard Children’s Hospital’s credit rating
Moody’s Investors Service downgraded Palo Alto, Calif.-based Lucile Packard Children’s Hospital’s credit rating to “A1” from “Aa3.”

5 hospitals with strong finances

http://www.beckershospitalreview.com/finance/5-hospitals-with-strong-finances-080117.html

Here are five hospitals and health systems with strong operational metrics and solid financial positions according to recent reports from Fitch Ratings, Moody’s Investors Service and S&P Global Ratings.

Note: This is not an exhaustive list. Hospital and health system names were compiled from recent credit rating reports and are listed in alphabetical order.

1. Coral Gables-based Baptist Health South Florida has an “AA-” rating and stable outlook with S&P. The system maintained key balance sheet metrics and generated better-than-projected financial results in fiscal year 2016, according to S&P.

2. Carolinas HealthCare System has an “Aa3” rating and stable outlook with Moody’s. The Charlotte, N.C.-based system has a track record of good financial performance, strong balance sheet metrics and a large scope of operations with multiple hospitals. Moody’s expects Carolinas HealthCare System to maintain stable leverage metrics while continuing to generate financial results at current levels.

3. Children’s Healthcare of Atlanta has an “Aa2” rating and stable outlook with Moody’s. CHOA is a leading provider of high acuity pediatric care in the Atlanta area and has favorable leverage metrics and a track record of strong margins and liquidity, according to Moody’s.

4. Cleveland Clinic Health System has an “Aa2” rating and stable outlook with Moody’s. The system has a track record of meeting operating challenges to sustain strong cash flow, exceptional fundraising capabilities, strong liquidity and a growing ability to leverage an international brand into revenue diversification, according to Moody’s. The debt rating agency expects Cleveland Clinic to manage execution risks of multiple strategies, as demonstrated in the past.

5. Broomfield, Colo.-based SCL Health has an “AA-” rating and stable outlook with Fitch. The system’s operating performance improved in fiscal year 2015, and SCL has sustained those results, according to Fitch. The system has manageable capital needs in the near term, a stable liquidity position and geographic diversity, with 12 hospitals in five markets across three states.

EHR installs carry huge financial risks, Moody’s says

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Hospitals run the risk of incurring operating losses, lower patient volumes and receivables write-offs if there are problems, Moody’s says.

Rolling out new electronic health record systems puts hospitals at a significant risk of financial losses, according to a new report by credit rating firm Moody’s.

“Hospitals run the risk of incurring operating losses, lower patient volumes, and receivables write-offs if there are problems with adoption of a new EMR system,” Moody’s said in its Monday report.

Add to that the operational and financial disruptions that typically accompany complex IT projects, and hospitals could find themselves walking an even thinner financial margin than they are used to, Moody’s said.

“In a sample of hospitals that have recently invested in major EMR and revenue cycle system conversions, increased expenses and slower patient volumes contributed to a median 10.1 percent decline in absolute operating cash flow and 6.1 percent reduction in days of cash on hand in the install year,” Moody’s found.

The good news is that many hospitals returned to pre-install levels within a year, owing to strong risk management.

When Epic Systems founder and CEO Judy Faulkner talked with Healthcare IT News at HIMSS17 last February, she said Epic customers had done well financially. True, Epic EHR installations cost millions of dollars. However, from 2004 to 2015, she said Moody’s and Standard & Poor’s statistics showed that Epic customers reaped profitability unsurpassed by clients who implemented her competitors’ EHRs.

Despite the risks, hospitals will continue to invest in EHRs, Moody’s said. Hospital executives want to improve patient safety, clinical quality and provide decision support. IT will also continue to be a selling point in physician recruitment and retention, as new data reporting will be required by Medicare for professional reimbursement.

While hospitals may be exposed to a number of risks during massive IT rollouts, the threats that come with cyber attacks make them even more vulnerable, according to Moody’s.

As example, Moody’s points to Hollywood Presbyterian Medical Center in Hollywood, California, which acknowledged paying ransom after an attack in 2016.

Moody’s expects cybersecurity to become an even stronger focus than it already is.

“As IT investments represent a growing portion of hospital budgets, an increasing amount will be allotted to guarding confidential patient data, which make hospitals a prime target for cyberattacks and ransomware events,” according to Moody’s. “We expect cybersecurity to be a primary focus of hospital management teams and their boards, with annual capital and operating budgets allotting appropriate levels of expenditures to protect patient data and testing vulnerabilities.”

15 hospitals with strong finances

http://www.beckershospitalreview.com/finance/15-hospitals-with-strong-finances-071117.html

 

Here are 15 hospitals and health systems with strong operational metrics and solid financial positions according to recent reports from Fitch Ratings, Moody’s Investors Service and S&P Global Ratings.

Note: This is not an exhaustive list. Hospital and health system names were compiled from recent credit rating reports and are listed in alphabetical order.

1. St. Louis-based Ascension Healthhas an “Aa2” rating and stable outlook with Moody’s. The health system has manageable leverage, limited debt structure risk and a large portfolio of sizeable hospitals, according to Moody’s.

2. Coral Gables-based Baptist Health South Floridahas an “AA-” rating and stable outlook with S&P. The system maintained key balance sheet metrics and generated better-than-projected financial results in fiscal year 2016, according to S&P.

3. Dallas-based Baylor Scott & White Healthhas an “Aa3” rating and stable outlook with Moody’s. The health system has strong cash flow margins and a favorable business position as the largest nonprofit health system in Texas, according to Moody’s.

4. Children’s Hospital of Philadelphiahas an “Aa2” rating and stable outlook with Moody’s. The hospital has a history of solid financial performance and strong fundraising capabilities, according to Moody’s.

5. Christiana Care Health Services has an “Aa2” rating and stable outlook with Moody’s. The Wilmington, Del.-based system has solid liquidity and a history of above average financial performance, according to Moody’s.

6. Greenville (S.C.) Health Systemhas an “AA-” rating and stable outlook with Fitch. The system has recorded dramatic improvement in its operations, posting operating income of $18.6 million in fiscal year 2016 and $20.9 million for the first six months of fiscal year 2017, according to Fitch.

7. Indianapolis-based Indiana University Health has an “Aa2” rating and stable outlook with Moody’s. The system has healthy margins and a strong market position, according to Moody’s.

8. Kaiser Permanente has an “AA-” rating and stable outlook with S&P. The Oakland, Calif.-based system has a strong enterprise profile with a favorable integrated business model, according to S&P.

9. Bryn Mawr, Pa.-based Main Line Healthhas an “Aa3” rating and stable outlook with Moody’s. The health system has a solid market position and additional support from independent foundations, according to Moody’s.

10. Columbus-based OhioHealth has an “Aa2” rating and stable outlook with Moody’s. The system has a strong market position, consistently healthy cash flow margins, a manageable debt load and a solid investment position, according to Moody’s.

11. Parkview Health System has an “Aa3” rating and stable outlook with Moody’s. The Columbia City, Ind.-based system has solid financial performance, healthy debt service coverage and has seen liquidity metrics improve, according to Moody’s.

12. Albuquerque, N.M.-based Presbyterian Health Serviceshas an “AA” rating and stable outlook with S&P. The system has a solid financial profile and a modest debt load, according to S&P.

13. San Diego-based Rady Children’s Hospital has an “Aa3” rating and stable outlook with Moody’s. The hospital has healthy balance sheet metrics and a strong market position in pediatric services, according to Moody’s.

14. Madison-based University of Wisconsin Hospital and Clinicshas an “Aa3” rating and stable outlook with Moody’s. The system has strong balance sheet resources and established clinical and academic market positions, according to Moody’s.

15. WellSpan Healthhas an “Aa3” rating and stable outlook with Moody’s. The York, Pa.-based system has a strong and broadening market position and a track record of healthy financial performance, according to Moody’s.

56 hospital, health system outlook and credit rating actions in June

http://www.beckershospitalreview.com/finance/56-recent-hospital-health-system-credit-outlook-rating-actions-in-june.html

The following hospital and health system rating and outlook changes and affirmations took place in June, beginning with the most recent.

Moody’s maintains stable outlook on for-profit hospital sector

http://www.beckershospitalreview.com/finance/moody-s-maintains-stable-outlook-on-for-profit-hospital-sector-033117.html

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Moody’s Investors Service has maintained its stable outlook on the U.S. for-profit hospital sector for 2017, as it expects higher reimbursement rates from private payers to drive revenue growth.

Over the next 12 to 18 months, Moody’s expects for-profit hospitals to benefit from a 1 to 2 percent rise in patient volumes. The debt rating agency said the increase will be driven by higher demand for healthcare services due to decreasing unemployment and an aging population. However, programs that aim to reduce utilization and cost of care will offset this positive trend, according to Moody’s.

The debt rating agency expects higher private payer rates to drive revenue growth at for-profit hospitals. Moody’s said this growth will be constrained by cuts to laboratory and outpatient reimbursement and reduced Medicaid disproportionate share hospital payments.

“Positive same-facility revenue growth and flat margins drive our stable outlook for the U.S. for-profit hospital sector,” said Moody’s Senior Vice President Jessica Gladstone. “Margins will hold steady as company-specific actions offset multiple industry challenges, including higher wage and benefits expense stemming from nursing shortages and increased physician employment.”

Many for-profit hospital operators are divesting less-profitable facilities and integrating acquisitions, which will benefit their margins, according to Ms. Gladstone.

35 financial benchmarks for healthcare executives

http://www.beckershospitalreview.com/finance/35-financial-benchmarks-for-healthcare-executives.html

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Key finance statistics

Source: Moody’s Investors Service, “Preliminary U.S. Not-for-Profit and Public Hospital 2014 Medians: Growth in Hospital Revenue Edges Ahead of Expenses in 2014,” May 2015.

Note: The preliminary medians are based on FY 2014 audited financial statements representing 48 percent of Moody’s rated portfolio. These medians primarily reflect audit year ends of Sept. 30, 2014 and prior.