Philadelphia-based Thomas Jefferson University has undergone a credit downgrade with cash flow margins expected to stay low for "several years," Moody's said March 30.

Grand Forks, N.D.-based Altru Health will need to borrow up to $125 million to cover the burgeoning costs of labor and supplies for its new hospital project, according to an April 5 Grand Forks Herald report. It is also cutting its numbers of executives.

After severe staffing shortages forced Madera (Calif.) Community Hospital to close in December 2022, the county is rolling out mobile health vans to cover gaps in care, local news outlet ABC30 reported April 5.

Visalia, Calif.-based Kaweah Health has lost $135 million between the start of the COVID-19 pandemic and October 2022, The Business Journal reported April 4.

Portland, Ore.-based Legacy Health has added a covenant regarding its days cash on hand numbers, according to an April 3 filing.

NYC Health + Hospitals serves approximately 50,000 unhoused patients across the city, about half of whom are in long-term shelters.

The environment for nonprofit hospitals and health systems remains highly challenging into 2023, and any eventual reversal of fortune will depend on expenses and not the value of investment portfolios, Fitch Ratings said.

A Delaware lawmaker has introduced legislation aimed at providing patients better protections against medical debt collection practices, NPR affiliate WHYY reported April 2. 

A representative from the Texas Hospital Association spoke out against a state bill that would require providers to send patients an itemized bill when billing for medical services, NBC affiliate KXAN reported April 3. 

CMS has issued its Inpatient Rehabilitation Facility Prospective Payment System proposed rule, which would increase payments to inpatient rehab facilities by 3.7 percent in 2024.

Tacoma, Wash.-based Virginia Mason Franciscan Health has laid off nearly 400 employees, most of whom are in non-patient-facing roles, The Seattle Times reported April 6.

The average amount billed to commercial payers each year by individual physicians varies greatly from specialty to specialty, with general surgery at the high end and pediatrics at the low end. 

Renton, Wash.-based Providence suffered its third credit downgrade in less than three weeks when Moody's revised a rating on bonds the 51-hospital system holds to "A2" from "A1."

Hospitals often charge lower cash prices than negotiated payer rates for the same service, a study published in the April issue of Health Affairs found. 

Rural hospitals are increasingly at risk of closing due to lack of funding. Between 2015 and 2019, the U.S. saw a 59 percent decline in the number of rural community hospitals. It's why the American Hospital Association is urging Congress to pass the Rural Hospital Support Act.

A group of three former board directors holding approximately 35.7 percent of Cano Health shares have formed a group to "enhance shareholder value" at the troubled Miami-based primary care provider, which could result in selling off certain assets.

Rhode Island Attorney General Peter Neronha filed a motion to intervene in the proposed development of the former Memorial Hospital in Pawtucket, the Providence Business News reported April 3. 

An analysis by the Employers Forum of Indiana says the state could save up to $2 billion if some hospitals lowered their prices. However, some hospital leaders say the group's assessment is inaccurate, Indiana Public Media reported April 3.

Here are six health systems that had their credit rating upgraded by Fitch Ratings, Moody's Investors Service or S&P Global Ratings in 2023:

Long Island Community Hospital in Patchogue, N.Y., an affiliate of the NYU Langone system, has been upgraded amid extensive investment and a $100 million capital commitment from its parent company.