The outlook for the U.S. not-for-profit healthcare sector remains negative as new uncertainties over Medicare and Medicaid funding and the potential for political gridlock on healthcare reform could worsen the low growth in revenue, Moody's Investors Service said in a report. The report outlined three major risks facing the U.S. not-for-profit healthcare sector. One is the pressure to acquire physician practices and other providers, in order to remain competitive, which may require raising capital. The second risk is the increasing need to acquire or work with insurers to transition from getting paid each time a patient is treated to new reimbursement methods. The third risk is the U.S. Supreme Court's decision on the healthcare reform law that allows states to opt out of enrolling more people under Medicaid.