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照片：Kittifan Teerawatanakul/Eye Em/Getty Images

Moody's Investors Service expects an increase in healthcare borrowing defaults in 2024 versus 2023, as more ratings migrate toward the lower-end of the credit spectrum.

穆迪投资者服务公司（Moody's Investors Service）预计，2024年与2023年相比，医疗保健借款违约率将有所增加，因为越来越多的评级会向信用范围的低端转移。

Many healthcare companies will have no other options but to default in 2024, according to the new report from Moody's.

穆迪（Moody's）的最新报告显示，许多医疗保健公司将别无选择，只能在2024年违约。

Reasons include excessive leverage, elevated interest rates and expiring interest rate hedges, according to the report based on 192 rated North American-based healthcare companies.

根据这份基于192家北美评级医疗保健公司的报告，原因包括杠杆率过高、利率升高和利率对冲到期。

Nearly 21% of the 192 rated healthcare companies were on Moody's B3 Negative and Lower List (B3N list) as of November 20, up nearly 18% as of end of year 2022.

截至11月20日，在192家评级为医疗保健公司的穆迪B3负面和较低名单（B3N名单）中，近21%的公司在2022年底上涨近18%。

Over 60% of the healthcare companies on the B3N List have weak liquidity.

B3N名单上超过60%的医疗保健公司流动性较弱。

While that is comparable to 2022, refinancing has become more challenging as lenders' appetite for highly-leveraged capital structures has markedly decreased, the report said.

报告称，虽然这与2022年相当，但随着贷款人对高杠杆资本结构的偏好明显下降，再融资变得更具挑战性。

As in 2022, over 90% of companies on the B3N List have excessive leverage, often a result of the aggressive M&A strategies employed by their private equity owners.

与2022年一样，B3N名单上超过90%的公司杠杆率过高，这通常是由于其私人股本所有者采用了积极的并购策略。

No large health systems were on the list, but it included at least one operator and manager of hospitals and outpatient services.

名单上没有大型卫生系统，但其中至少包括一家医院和门诊服务的运营商和管理者。

In general, strategies implemented by private equity firms have left some companies – including physician practices, emergency medicine and anesthesiology – with high debt loads, which has limited their ability to adapt to economic and industry changes, the report said.

报告称，总体而言，私人股本公司实施的战略使一些公司（包括医生执业、急诊医学和麻醉学）背负着沉重的债务负担，这限制了它们适应经济和行业变化的能力。

Moody's called out Envision Healthcare Corp., a provider of emergency services and among the largest rated private equity-owned healthcare companies, as facing multiple challenges. Envision filed for Chapter 11 bankruptcy earlier this year.

穆迪称，应急服务提供商Envision Healthcare Corp.面临多重挑战，该公司是评级最高的私人股本拥有的医疗保健公司之一。Envision在今年早些时候申请了第11章破产保护。

The physician staffing company was under pressure due to the passage of the No Surprises Act in 2022, which banned surprise medical bills for out-of-network services and aggressive financial policies reflected in very high debt levels, Moody's said.

穆迪表示，由于2022年通过了《无意外法案》，这家医生配置公司面临压力，该法案禁止为网络外服务支付意外医疗费用，以及反映在极高债务水平上的激进金融政策。

WHY THIS MATTERS

为什么这很重要

Companies will have to restructure debt or default well ahead of maturity walls that remain modest in 2024 but accelerate in 2025, Moody's said.

穆迪表示，公司将不得不在到期墙之前重组债务或违约，到期墙在2024年保持适度，但在2025年加速。

Ten healthcare companies have defaulted year-to-date, and nine that were already rated B3 negative or lower have been downgraded further, the report said.

报告称，今年迄今已有10家医疗保健公司违约，其中9家评级为B3阴性或更低的公司被进一步降级。

In addition to high interest expenses and high leverage, many of the companies on the list are also contending with ongoing industry challenges including continuing pressure by private and public payers to reduce healthcare costs and operating cost inflation.

除了高额利息支出和高杠杆率外，名单上的许多公司还面临着持续的行业挑战，包括私人和公共付款人持续施加压力，以降低医疗保健成本和运营成本通胀。

Healthcare companies' performance has taken a hit from labor cost inflation and adverse changes to industry dynamics.

医疗保健公司的业绩受到劳动力成本上涨和行业动态不利变化的冲击。

THE LARGER TREND

更大的趋势

Improving operating conditions, restructuring measures, amend and extend debt transactions and equity infusions have helped a small number of companies ward off defaults. However, these measures may only provide temporary relief, especially if current macroeconomic headwinds do not subside.

改善经营条件、重组措施、修订和扩大债务交易和股权注入，帮助少数公司避免了违约。然而，这些措施可能只能提供暂时的缓解，尤其是在当前宏观经济逆风没有平息的情况下。

Since March 2022, the Federal Reserve has raised its base rate by 500 basis points to 5.25%, while credit spreads have also widened, further adding to the cost of borrowing.

自2022年3月以来，美联储将基准利率提高了500个基点，至5.25%，同时信贷利差也扩大了，进一步增加了借贷成本。

Twitter: @SusanJMorse

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