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A unique rural-academic partnership has enabled a critical access hospital to significantly expand access to services. At the same time, careful financial planning has supported debt issuance for a state-of-the-art facility for the community.

Hospitals seeking funds for capital needs are facing several challenges, which is driving interest in non-traditional financing structures, often involving real estate. Synthetic leases are one alternative, but they require a careful assessment of both their benefits and considerations that may make them a less attractive option.

Favorable execution levels for basis swaps can emerge quickly, and last for a short period of time. Health systems that have laid the groundwork for execution of a basis swap are positioned to promptly take advantage of what may be a short-lived opportunity.

A changing interest rate environment has reopened the opportunity to consider terminating an organization’s swap position. Organizations should take a measured approach in determining whether this is an opportunity they wish to pursue.

Recently, Erik Swanson and Robert Turner joined the Reorg podcast with reporter Hoa Nguyen to explore hospital financial performance and healthcare financing trends through the rest of 2023.