In a review of 29 Illinois hospital bond ratings, Moody's Investors Service lowered six ratings and confirmed 23. The ratings represent $1.8 billion in outstanding debt.
The six downgrades, representing $262.6 million in debt, are related to various industry trends, including competitive market conditions, increased pricing pressures and variable financial performance.
The update of unenhanced hospital bond ratings in Illinois is part of Moody's state-by-state review of hospital debt.
Columbus-Cabrini Medical Center, whose rating was lowered to Baa from Baa1, and Mercy Hospital and Medical Center, whose rating was downgraded to Baa1 from A, are in Chicago.
The downgrades also affected two Peoria providers: Methodist Health Services (to Baa1 from A) and Proctor Community Hospital (to Baa from A).
The debt ratings of Riverside Health System/Riverside Senior Living Center in Kankakee (to Baa1 from A) and St. Elizabeth Medical Center in Granite City (to Baa from Baa1) also were lowered.
Ratings on four other Illinois hospitals and systems remain under review pending upcoming bond sales or restructurings.
Moody's said it will continue to monitor the state's Medicaid program and its impact on hospital ratings. Earlier this year, the state froze Medicaid rates and extended the payment cycle. The state also plans to implement a Medicaid managed-care program.