The marginal effect of bond insurance on hospital, tax-exempt bond yields

In response to changes in the health care environment and the tax-exempt bond market, many hospitals have purchased bond insurance and other forms of credit enhancement to lower the yields on their debt financings. This study of tax-exempt revenue bonds issued by hospitals from 1982-84 estimates that bond insurance lowers yields on hospital bonds by approximately 87 basis points and that bond insurance serves as a substitute measure of creditworthiness. The findings also suggest that the insured group of hospital bonds is more homogeneous than the uninsured group in terms of characteristics that affect the risks associated with hospital investments. Insured bonds seem to represent hospitals in an intermediate risk group.