Downgrades of acute-care hospital bond ratings slowed in the first nine months of 2004 but still outpaced upgrades by a ratio of 2.8-to-1, Fitch Ratings said. By comparison, the ratio in the first nine months of 2003 was 6-to-1. The gain reflects an overall improvement in business strategies and management practices, continued revenue growth and good managed-care reimbursement, the ratings agency said. Still, uncertainty will continue among acute-care hospitals because of growing capital needs, expense pressures, increased competition from doctors and possible cost-containment efforts by state and federal healthcare programs. Of the 18 downgrades in Fitch's healthcare group during the nine-month period, 17 were acute-care hospitals. All of Fitch's six healthcare upgrades were acute-care hospitals. Healthcare bond issues in the nine months totaled $19.4 billion, a decrease of about 6% from the year-ago period. -- by Paul Barr
Downgrades slow amid better business practices
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