This is Gonna Cost You
"It's a problem," says one hospital system chief financial officer I spoke to recently who has about $400 million in debt though auction rate securities backed by Financial Guaranty Insurance Company--a bond insurer whose paper no one wants to buy. "Our interest rates have skyrocketed," he says. "We're all spending a lot more in interest right now, and we're all trying to get to market as fast as possible to refinance everything."
A key characteristic of auction-rate debt instruments is that they must periodically be re-sold in a Dutch auction. When the market is working right, institutional investors bid on debt issued by cities and hospitals based on credit ratings and--sometimes--enhanced credit ratings provided by bond insurers that stand behind those debt issuers. The investor that's willing to take the lowest interest rate wins the auction. This is an active auction market. The bonds are re-bid, typically, every seven, 28 and 45 days. The problem is, no one trusts that so-called bond insurers are able to make them whole in the unlikely event of a default, therefore no one is bidding. That means the borrower has to pay the default rate that's listed in the bond contract with the investment bank, which is extremely high--in some cases, up to 17 percent. Those kinds of rates haven't been seen in more than a quarter century.
Many hospitals and municipalities used auction rate debt until very recently to diversify their debt portfolio and manage their interest rate risk--or so they thought. For the most part, hospitals and municipalities are extremely safe bets. But because they relied on rating agencies and bond insurers to guarantee repayment, they're paying the price for those entities' mistakes outside the municipal debt markets. No one believes they can actually "insure" in case of default. Truth is, because of mistakes they made with risk assessment in a totally unrelated market--home mortgages--they can't.
In some cases, hospitals that have stellar repayment histories and credit ratings are paying as much as 15 percent interest on bonds that were generating perhaps 5 percent before the credit crisis hit. No one--not the bankers, not the borrowers, not the investors--thought this risk would ever come to pass. It's a doomsday scenario, but it's one that's going to cost hospitals big-time, at least in the short term.
"I am sure it feels like hitting an iceberg," says Arlan Dohrmann, an investment banker with Stern Bros. & Co., whose firm doesn't deal in these securities. "It's a risk that was there but not totally visible."
"I'm surprised I'm not reading more about it," the CFO I interviewed says about hospital debt, "because it's taken over all the time of accountants, investment bankers and CFOs."
Give it time. Just give it time.
Editor's note: Does your hospital or health system have any auction-rate debt? If so, I'd love to hear from you about how you're navigating this storm. Please e-mail me at the address below.
Philip Betbeze is finance editor with HealthLeaders magazine. He can be reached at email@example.com.
- Readmissions: No Quick Fix to Costly Hospital Challenge
- Ebola: Health Officials Try to Quell Front Line Fears
- House Calls Key to Pioneer ACO Success
- How Telehealth Pays Off for Providers, Patients
- Defensive Medicine Still Prevalent Despite Tort Reform
- Reducing Readmissions Starts with Better Collaboration
- 'Overtreatment' Debate Circles Back to Lung Cancer Screening
- How Top-Ranked MA Plans Earn Their Stars
- Partners HealthCare M&A Deal Under Scrutiny
- How Educated Nurses Save Money