Multiple health systems and municipalities have suffered downgrades to their financial ratings due to rising expenses, operating losses, and high debt levels, with Moody's downgrading Quincy, MA for debt reaching $1.8 billion and reserves falling to 1.5% of revenue.
ReadingBond buyers should price in a second wave of healthcare downgrades. Reserves below 2% are no longer acceptable to rating agencies. Systems in that bucket will face higher borrowing costs within 90 days.
WatchWatch for a major health system (not Quincy scale) to be downgraded. That will trigger refinancing cascades across the sector.