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Abstract: 

What are the credit implications of the Affordable Care Act for U.S. hospitals and healthcare systems? How do the implications differ in states that have expanded Medicaid and states that have not? And what are the implications for academic medical centers? This paper addresses the details that should be the focus of bond investors now that the ACA has been implemented. Jim Gilliland is senior vice president at Diversified Trust. Anu R. Singh is managing director at Kaufman Hall. Lisa Zuckerman is senior vice president of treasury & strategic investments at Dignity Health. Chris McLean is chief financial officer at Methodist Le Bonheur Healthcare (TN). This discussion is based on the authors’ presentations in the panel titled “Affordable Care Act: Credit Implications on U.S. Hospitals” at the 32nd Annual Conference of the National Federation of Municipal Analysts in Las Vegas, Nevada, May 12–15, 2015.

Keywords: Affordable Care Act, Medicaid, healthcare bonds, bond ratings, readmission penalties

Affiliations:  1: Diversified Trust; 2: Kaufman Hall; 3: Dignity Health; 4: Methodist Le Bonheur Healthcare.