...Widening Credit Gap: Median operating profitability metrics exhibited strong gains over the past year, driven by the realization of performance improvement plans and improved utilization and payor mix from Medicaid expansion (for certain states) and healthcare exchange enrollment. However, the growth in operating cash flows were concentrated in the `A' and `AA' rating categories, highlighting the widening credit gap between higher- and lower-rated borrowers. The median operating profitability metrics for `BBB' rated issuers declined year over year, continuing its negative trend since 2011 and illustrating the particular challenges faced by mostly smaller healthcare providers. Strengthened Liquidity: Key median liquidity metrics improved, consistent with last year's results. Fitch Ratings attributes the strengthening to a combination of improved or steady cash flows, strong investment returns, lower capital spending and diligent revenue cycle management initiatives. While further revenue...
