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Updated: May 24, 2026

An R-Based Landscape Validation of a Competing Risk Model

An R-Based Landscape Validation of a Competing Risk Model

Published on: September 16, 2022

Market turbulence creates financing opportunity.

James H Cooper¹

¹AMS Health Care Mortgage Corporation, Jacksonville, Fla., USA. jcooper@amshcm.com

Healthcare Financial Management : Journal of the Healthcare Financial Management Association

|March 17, 2012

Summary

This summary is machine-generated.

Following a U.S. credit rating downgrade, hospitals can leverage favorable interest rates on Government National Mortgage Association (GNMA) securities for financing. This strategy offers a cost-effective alternative to traditional tax-exempt bonds, mitigating negative arbitrage risks.

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Last Updated: May 24, 2026

An R-Based Landscape Validation of a Competing Risk Model

An R-Based Landscape Validation of a Competing Risk Model

Published on: September 16, 2022

Area of Science:

Health Economics
Financial Markets
Public Finance

Background:

* U.S. government credit rating downgrade by Standard & Poor's led to a flight to quality assets.
* This resulted in decreased yields on U.S. Treasury securities due to market uncertainty.
* Hospitals faced challenges in financing expansions and refinancing debt.

Purpose of the Study:

* To explore the financial implications of the U.S. credit rating downgrade for hospital financing.
* To analyze the benefits of using Government National Mortgage Association (GNMA) securities for hospital debt.
* To assess the potential for cost savings and risk mitigation in hospital capital projects.

Main Methods:

* Analysis of U.S. Treasury yields and market conditions post-credit rating downgrade.
* Examination of hospital financing options, including government-insured mortgages and GNMA securities.
* Comparison of interest rates between GNMA securities and tax-exempt bonds.
* Evaluation of forward purchase transactions for GNMA certificates to manage interest rate risk and negative arbitrage.

Main Results:

* Lower yields on U.S. Treasury securities created a more favorable environment for borrowing.
* Hospitals can obtain government mortgage insurance for financing expansions and debt refinancing.
* GNMA securities offer taxable interest rates potentially more advantageous than tax-exempt bonds.
* Forward purchase transactions for GNMA certificates lock in rates and defer interest payments, avoiding negative arbitrage.

Conclusions:

* The U.S. credit rating downgrade inadvertently created a beneficial financing opportunity for hospitals.
* Utilizing GNMA securities presents a strategic financial advantage for hospital capital investments and debt management.
* This financial mechanism allows for more predictable and potentially lower-cost financing compared to traditional methods.