Standard & Poor's Corp. this month said it has fine-tuned its analysis of health care credits in response to market-driven changes in the industry.

Increased competition, consolidation, and managed-care contracting, which is a key element of President Clinton's health care reform plan, reflect the forces that are reshaping the health care industry, Standard & Poor's said in a comment in the Dec. 6 issue of CreditWeek Municipal

Joan Pickett. a director at Standard & Poor's, said the rating agency continues to emphasize qualitative and quantitative factors in determining health care ratings nationally, but that in highly competitive areas several rating factors warrant a thorough examination. The factors include a provider's competitive position, cost structure, and relationship with other providers, physicians, and insurers, Pickett said.

In highly competitive markets, low-cost efficient providers that offer quality care will be more successful in winning and retaining managed-care contracts than other providers, Standard & Poor's said.

Financial position and performance remain important in its analyses, Standard & Poor's said. Institutions that have accumulated healthy cash positions while adequately maintaining their plants will be better able to withstand anticipated decreases in government reimbursements, pay for capital improvements, and enter into new business arrangements.

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