The rating affirmation was supported by a number of factors, including the system’s solid operating cash flow margins, which have averaged 14 percent for the last three years. The rating affirmation was also supported by CHKD’s dominant 90 percent inpatient market share, as it is the only free-standing children’s hospital in Virginia.
The system also faces some challenges, which were considered for the rating affirmation, such as relying heavily on Medicaid and disproportionate share reimbursement.
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