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Rating downgrades exceeded upgrades for all three rating agencies in 2022. Below are five key takeaways: Downgrades covered a wide swath of hospitals including single site hospitals and...

As we move into 2023, hospital and health system leaders will need to bring the full range of available resources to bear against a continuing barrage of operating and financial headwinds.

The defining characteristic of 2023 is the multi-variable set of high-impact unknowns. The only way to push back is to bridge the management of scarce resources across the very different operating, financing, and investing functions that define every not-for-profit health system.

Although hospitals have experienced difficult operating periods and volatile stock markets in the past, the simultaneous impact of these two forces in 2022 was a first in not-for-profit healthcare, creating a financial “twindemic” that drove many of the downgrades.

In this summary of our Healthcare Leadership Conference rating agency panel, the agencies’ not-for-profit healthcare leaders address issues related to financial performance, covenant management, and ESG.

Tuesday’s 7.1% CPI print was an improvement from October’s 7.7% and well off the 9.1% peak (so far) posted in June. 7.1% is not price stability and there remains a large gap to the Fed...

While inflation may be stabilizing, healthcare organizations face a long haul back to a better place. They will need a disciplined framework and an openness to new possibilities, including the utilization of strategies that were rejected in more stable times.

In recent months, hospitals of all sizes and ratings are reporting tremendous financial turbulence, primarily due to externalities such as the nursing shortage and the need for expensive contract labor.

Not-for-profit healthcare investors provide their perspectives on issues including weak financial performance and the threat of breached covenants, best practices for disclosure and transparency, and the growing influence of ESG concerns on investment decisions.

The Federal Reserve’s transition from interventionist back to influencer will impact every corner of the modern healthcare enterprise and should be on the list as you reassess post-inflation resource positioning.

We are in a very complicated credit moment and an equally complicated capital structure environment. Capital access remains a critical success factor, and today’s work is to reassess where you want to be on the risk-optionality continuum.

Provisions of the recently enacted Inflation Reduction Act now allow the federal government to provide a direct payment for qualifying renewable energy projects owned by tax-exempt entities.