The rating on Vermont Educational and Health Building Finance Agency's bonds, issued for Springfield Hospital (Springfield), reflects: Springfield's relatively small size, A moderate dependency (44%) on governmental payors, Balanced Budget Act (BBA) reimbursement pressures, and Rising costs associated with increased utilization. Positive factors include Springfield's: Strong primary-care market position, Strong coverage, Adequate liquidity, and Low debt. The bonds are secured by net revenues of the hospital. Direct competition in the hospital's large, rural primary service area is limited, with Springfield serving a consistent 60% of the market based on admissions. In addition, the hospital solidifies its primary-care market position by employing the majority of the area's physicians. However, a substantial 25% of the service area's discharges goes to Mary Hitchcock
