title: Clinical quality is independently associated with favorable bond ratings.
abstract: The relation between clinical quality and bond rating for nonprofit hospitals has been proposed but never fully studied. We analyzed the relation between bond rating, clinical quality measures (The Joint Commission/Centers for Medicare and Medicaid Services [CMS] core measures), and balance sheet and income statement financial measures of 236 hospitals across the United States that are rated by Moody's Investors Service and that reported clinical quality measures to CMS during the study period. We found a statistically significant relation between higher quality measures and more favorable bond ratings. This association remained significant after controlling for traditional financial parameters.
authors.affiliation: Baylor Health Care System, Dallas, TX 75206, USA. ziadh@baylorhealth.edu
authors.forename: Ziad
authors.initials: Z
authors.lastname: Haydar
authors.forename: David
authors.initials: D
authors.lastname: Nicewander
authors.forename: Paul
authors.initials: P
authors.lastname: Convery
authors.forename: Michael
authors.initials: M
authors.lastname: Black
authors.forename: David
authors.initials: D
authors.lastname: Ballard
mesh_terms: D002202:Capital Financing / Q000145:classification* / Q000706:statistics & numerical data; D002983:Clinical Competence / Q000191:economics / Q000592:standards*; D017598:Efficiency, Organizational / Q000191:economics*; D005377:Financial Management, Hospital / Q000145:classification*; D006788:Hospitals, Voluntary / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007449:Investments / Q000145:classification* / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D019984:Quality Indicators, Health Care; D014481:United States