Association of HMO penetration and other credit quality factors with tax-exempt bond yields

This paper evaluates the relationship, of HMO penetration, as well as other credit quality measures of market institutional, operational, and financial traits, to tax-exempt bond yields. The study analyzed more than 1,500 bond issues from 1990 through 1993 and corrected for simultaneous relationships between bond size and yield and selection bins. The study found lower bond yields for hospitals located in markets with no HMO penetration. Lower yields for bond issues also were found for facilities generating higher numbers of days cash on hand and greater debt service coverage. Finally, results show that hospitals with higher occupancy rates achieve a lower yield.