CHICAGO -- A group of hospitals in Nebraska is better positioned to weather upcoming national health-care reforms than other institutions across the country, according to a study released recently by Van Kampen Merritt Investment Advisory Corp.
Eleven Nebraska hospitals analyzed in the study have good liquidity, strong cash reserves and low debt ratios, which could give them an edge in adapting to imminent health-care changes, said Michael D. Jurecki, an associate municipal analyst at the advisory firm based in Oakbrook Terrace, Ill.
"It was a pleasant surprise," Jurecki said, referring to the results of the study. The study, which analyzes 1992 data of over 2,000 hospitals nationwide, supports Nebraska's reputation for fiscal conservatism, he said.
In its July 5 MuniWeek newsletter, Van Kampen Merritt said hospitals with good current ratios of assets to liabilities and strong cash reserves are "likely to be able to absorb any short-term negative impacts of reform, while hospitals with a low to moderate degree of leverage appear to have the borrowing capacity necessary to retool for the new health-care environment."
A national health reform plan being drafted by the First Lady, Hillary Rodham Clinton, is expected to be unveiled in September.
The 11 Nebraska hospitals in the Van Kampen Merritt study are more active in the bond market than other health-care issuers in the state, Jurecki said. They are also the largest hospitals in the state, with total patient capacities ranging from 140 to 400 beds, he said.
Nebraska hospitals outpace other institutions across the country in several important categories, Jurecki said. For example, the state has a median of 106.6 days cash on hand, compared to the national median of 83.4 days. The state's median long-term debt to capital ratio is 34.7%, compared to the national median of 44.5%.
John Goetz, vice president and manager of health-care finance at Moody's Investors Service, said the financial strength of Nebraska hospitals is derived partly from the state's diversified economy with low unemployment.
The state also does not regulate patient care rates, giving hospitals the flexibility to raise prices to meet their expenses, Goetz said.
Joan Pickett, a director at Standard & Poor's Corp., said Nebraska hospitals are typically "non-urban" facilities that do not experience the same competitive pressures found in more urban or over-bedded areas. She added that many of the Nebraska hospitals are sole community providers or regional referral centers.
Much of the debt issued by Nebraska hospitals is enhanced because of their limited access to the capital markets, Pickett said.
But Harlan Heald, president of the Nebraska Hospital Association, attributed the strong showing of Nebraska hospitals in the Van Kampen Merritt study to their conservative approach to financial management.
"The nature of the people who live here and who serve on hospital boards have the Midwest agrarian mind-set -- that you don't spend it till you got it," Heald said.
Charles Marr, president and chief executive officer of Immanuel Medical Center in Omaha, one of the hospitals in the Van Kampen Merritt study, agreed that Nebraska hospitals are fiscally conservative.
"It is just sort of a definite mind-set that we can invest in capital equipment, but we must make sure we have adequate dollars," Marr said.
Referring to hospitals in the Omaha area, Nebraska's largest metropolitan center, Marr said that they receive strong support from their hospital boards of directors and the community in fund-raising efforts. He added that Omaha is also a referral center serving people within a 120-mile radius of the city, including Council Bluffs, Iowa, located across the Missouri River.
The other 10 hospitals cited in the study are Bryan Memorial Hospital in Lincoln, Clarkson Bishop Memorial Hospital in Omaha, Good Samaritan Hospital in Kearney, Great Plains Regional Medical Center in North Platte, Lincoln General Hospital in Lincoln, Lutheran Community Hospital in Norfolk, Mercy Midlands & Affiliates in Omaha, Midlands Community Hospital in Papillion, Regional West Medical Center in Scottsbluff, and Catholic Health Corporation in Omaha, which includes Archbishop Bergan Mercy Hospital in Omaha.