【出版时间及名称】：2009年12月美国医疗设备行业研究报告
        【作者】：摩根斯坦利
        【文件格式】：PDF
        【页数】：143
        【目录或简介】：
Healthcare Facilities
Pricing Sustainability a
Looming Issue; Cautious View
Initiating coverage of five hospital management
companies with Cautious industry view — LPNT
(Overweight), UHS and THC (Underweight), and CYH
and HMA (Equal-weight). Though near-term
fundamentals are relatively steady, the risk/reward
appears less favorable after the 100% upward move in
2009, given longer-term challenges.
This report includes a proprietary in-depth review of
profit and cash flow drivers (pages 5, 11–44) for the
sector. Several areas worth highlighting:
Sustainability of pricing is an issue. Pricing outlook
(a bright spot in recent years) may reach a negative
inflection point in the next 12 months. Though 2010
pricing is largely already set, we expect a more
challenging backdrop for both commercial and
government reimbursement looking out to 2011–12.
Commercial pricing will likely become increasingly
contentious, driven by greater employer/consumer cost
sensitivity. In addition, we expect continued payor mix
deterioration, and pressure on government payor
reimbursement growth rates.
Bad debt likely to become more challenging. We
expect bad debt expense to rise 50–150 bps through
2012 as buy-downs continue, pressing collections of
balances after insurance, with uninsured self-pay and
payor disputes more likely to grow in line with revenue.
This pressure seems more visible than any potential
offset from stabilizing unemployment in 2010 (as
COBRA subsidies in 2009 mitigate this impact).
Relative valuations not compelling. After more than
doubling in 2009, hospitals trade at 10.9x P/E with FCF
yields of ~8–9%. For comparison, this is a 20%
premium to the MCOs, nearly double the level seen over
the last 5 years. We also believe MCOs are
fundamentally better positioned in the event we enter a
rising interest rate environment.