... debt/EBITDA at Dec. 31, 2015 of 2.0x is the strongest among Fitch-rated hospital companies and much improved compared to 3.6x pro forma for the November 2010 acquisition of Psychiatric Solutions, Inc. (PSI). A focus on debt repayment and recent EBITDA growth has led to much-improved credit metrics. Strong Cash Flows: Cash flows are supported by improved acute care volumes and the coverage expansion components of the Affordable Care Act (ACA). FCF was $539 million in fiscal 2015. Cash flow improvements will be more closely tied to success in growing outpatient capabilities over the ratings horizon. Diversification, Stability from Behavioral Health: The behavioral health business affords UHS increased business and revenue diversification, as well as improved financial stability and profitability. Good organic growth in the mid-single digits and moderately improving profit margins are expected over the ratings horizon. Recent acquisitions are...
