【出版时间及名称】：2010年4月美国医疗行业研究报告
        【作者】：德意志银行
        【文件格式】：pdf
        【页数】：152
        【目录或简介】：

Industry Overview and Outlook
􀀟 Summary Overview of the High Yield Health Care Market
􀀟 High Yield Health Care Index Return
􀀟 New High Yield Health Care Issuance; Death Care, Hospital and SNF Relative
Value Tables
􀀟 Sector Recommendation: Change to Market Weight
􀀟 Selected Recommendations:
􀀟 BioMet Inc: Swap into the Seniors from either the Toggles or Subs
􀀟 DJO: 10 7/8% BUY to HOLD; 11 3/4% Maintain BUY
􀀟 HCA: Maintain Hold with best value in second liens
􀀟 IASIS: HOLD to SELL due solely to price
􀀟 SEM: Hold to BUY
􀀟 USPI: BUY to HOLD
􀀟 4Q09 Company Reviews; Outlook for 1Q10 & Full Year 2010
􀀟 Financial Summaries
􀀟 At a Glance Relative Value Tables and Estimates

Overview and Outlook
The high-yield market is continuing its remarkable run with the appetite for risk increasing.
Spreads have narrowed dramatically. The Deutsche Bank Global High Yield Index is now
yielding 7.95%, down from 16.9% a year ago. There is also little perceived benefit to owning
paper in a defensive sector like health care with the yield to the Deutsche Bank Health Care
Index at 7.6%, only 35 basis points inside the broader index. With health care reform now
behind us and, as expected, little done in the way of cutting provider payment, we believe
health care will remain a defensive sector. Therefore, it makes sense to maintain a sizable
investment in health care paper. However, with the economy seemingly still recovering,
there is no obvious benefit to overweight health care. As a result, we change our
Overweight recommendation on the sector to Market Weight.
Government Reimbursement
As is well known, the health care reform bill has been signed by President Obama. The
savings demanded from health care providers are not particularly onerous since most of
them come from cuts to the Medicare Advantage program and from reducing the annual
growth rates of the various Medicare inflationary market basket increases by a certain
percentage. Most of these reductions are back-end loaded. Outlines for the reductions to
the market basket increases are shown below. Unless the U.S. develops the political
mindset to rein in government spending, we see little likelihood that Congress will have the
political will to allow these reductions to be implemented over multiple years. On balance,
most market baskets usually increase 2-3% annually.
The Congress has yet to fix the physician fee schedule. While we see virtually no chance the
fee schedule will be cut permanently, by law, since April 1, 2010, the 21% cut has been in
effect. There are currently two bills pending that would delay the cut. The first pushes the
cut out until the end of April and the second until the end of September. Of note, the second
Bill (H.R 4213) also includes the FMAP extensions through June 30, 2011. Many state
governors are counting on the passage of this legislation to supplement their Medicaid
spending.