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Health systems consider returning to financing derivatives as a result of 2017 tax law
Modern Healthcare

Advance refunding—issuing a tax-exempt bond to refund an existing one—used to be a not-for-profit hospital’s screwdriver, a tried and true instrument for managing debt found in just about every chief financial officer’s toolbox.

Since the Tax Cuts and Jobs Act disallowed that strategy at the beginning of 2018—a change many are still working to reverse—financial advisers, bankers and lawyers predict this year some not-for-profit health systems will consider a portfolio of alternative maneuvers they may not have thought about before. That would include so-called Cinderella bonds, multistep derivatives and plain old vanilla swaps.