Moody’s also affirmed a stable outlook for the health system. The bond rating reflects the system’s trend of strong operating performance (18.6 percent operating cash flow margin in fiscal year 2013), leading market share and low debt burden (20 percent debt to revenue), according to Moody’s. Saint Francis has also experienced growth of unrestricted cash and investments.
However, the system also faces some fiscal challenges, including operating in the competitive Tulsa marketplace, financing capital projects and increasing Medicaid exposure in a state that hasn’t expanded its program under the Patient Protection and Affordable Care Act, according to Moody’s.
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