Hospitals with high percentages of Medicaid patients often have stretched budgets. With state and federal cuts for the insurance program for the poor going into effect, those budgets are likely to be strained even further.
Moody's Investors Service recently released a report indicating the delays of the employer insurance mandate under the Patient Protection and Affordable Care Act are a "credit negative" action, especially for hospitals with high proportions of Medicaid patients.
Delays of the insurance mandate postpone coverage for the uninsured, which was one of the primary benefits of the law for nonprofit hospitals. Consequently, bad debt is likely to increase, and hospitals with Medicaid-heavy payer mixes will have to fight to maintain their margins.
Within the report, Moody's analysts listed the top 10 hospitals and health systems in its rated portfolio that have the highest Medicaid mix as a percentage of their gross revenue. Moody's does not necessarily plan to downgrade the hospitals, but the ratings agency "will monitor the ultimate credit impact on them."
Here are the 10 nonprofit hospitals and health systems that are most exposed to Medicaid in Moody's portfolio. Note: To see the 15 nonprofit hospitals and health systems that are most exposed to Medicare in Moody's portfolio, click here.
Hospital/Health System |
Moody's Credit Rating |
Rating Outlook |
Medicaid as % of Gross Revenue |
Hurley Medical Center |
Ba1 |
Stable |
39.7% |
Loma Linda (Calif.) University Medical Center |
Baa3 |
Negative |
35.6% |
The MetroHealth System |
A3 |
Negative |
33.3% |
Westchester Medical Center (Valhalla, N.Y.) |
A3 |
Rating Under Review |
33.1% |
Community Medical Centers |
Baa2 |
Positive |
33% |
Einstein Healthcare Network (Philadelphia) |
Baa2 |
Stable |
30.9% |
University of Florida Health Jacksonville |
Baa3 |
Stable |
29.5% |
Antelope Valley Hospital |
Ba2 |
Negative |
29.3% |
Holyoke (Mass.) Medical Center |
Ba3 |
Negative |
29.3% |
Mission (Texas) Regional |
Baa2 |
Negative |
28.3% |
More Articles on Hospitals and Medicaid:
Hospitals in Red States Continue Push for Medicaid Expansion
Moody's: Academic Medical Centers Maintain Strong Credit
Fitch: 2014 Does Not Look Good for Nonprofit Hospitals