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Rating Action:

Moody's assigns Aa3 to Allina Health System's (MN) Series 2021; outlook negative

25 Oct 2021

New York, October 25, 2021 -- Moody's Investors Service has assigned a Aa3 to Allina Health System's (MN) proposed $300 million Taxable Bonds Series 2021 and its proposed $200 million Health Care System Revenue Bonds, Series 2021 (Allina Health System). At the same time, Moody's affirmed Allina Health System's (Allina Health) existing Aa3 revenue ratings. The outlook is negative. Allina Health will have about $1.7 billion in debt outstanding following this transaction.

RATINGS RATIONALE

The assignment and affirmation of Allina Health's Aa3 ratings reflect its strong days cash and favorable market position, anchored by its flagship tertiary and quaternary facility, Abbott Northwestern Hospital. This will help position the system amid a rapidly changing payer environment highlighted by the entry of for-profit national plans over the past few years. Partnerships with various insurers will facilitate management's goal to derive more revenue from population health models. To further support its value-based strategies and its presence in the competitive Twin Cities, Allina Health will continue to expand its ambulatory surgery platform as well as its oncology service. Following a challenging fiscal 2020, 2021 operating cash flow (OCF) margins will likely be considerably stronger. Sustained margin improvement will be important as the system deleverages following a material (over 40%) rise in debt and weakened debt measures. That said, heightened wage pressure and volume softness will remain strong headwinds to financial improvement. The effect on cash to debt will be somewhat muted by taxable proceeds that will remain on balance sheet as management will likely fund capital spend with operating cash flow.

RATING OUTLOOK

The negative outlook reflects Moody's view that management's ability to deleverage from a material increase in debt will prove challenging, particularly because improvement in OCF margins is uncertain. Failure to sustain recent improvement in OCF margins could result in a downgrade.

FACTORS THAT COULD LEAD TO AN UPGRADE OF THE RATINGS

- Material improvement and durability of OCF margins; significantly lower debt to cash flow

- Meaningfully stronger days cash and cash to debt

- Improved geographic reach, diversity and scale

- Evidence of ability to successfully navigate a more aggressive payer environment and risk sharing

FACTORS THAT COULD LEAD TO A DOWNGRADE OF THE RATINGS

- Inability to sustain OCF margins at levels in line with improved interim financials

- Absence of meaningful deleveraging as measured by debt to cash flow and cash to debt

- Decline in days cash

- Negative effects from insurers

LEGAL SECURITY

The bonds will be secured by a security interest in Pledged Revenues of the Obligated Group Members, which consists primarily of Allina Health's 10 owned and operated and one jointly owned and operated hospitals, representing approximately 98% of total system fiscal 2020 revenues. Management is seeking to amend certain covenants applicable to the current offering. However, these changes would spring into effect upon receipt of approval of bondholders with greater than 50% of outstanding bonds. With this financing, management is proposing to include force majeure as an exception to an event of default. Following this financing, amendments made in conjunction with the May 2019 financing would spring into effect once management attains all necessary approvals. Amendments in 2019 included a change to acceleration provisions that would require a majority of bondholders, up from 25%.

USE OF PROCEEDS

Taxable proceeds will be used for general corporate purposes. Tax-exempt proceeds will be used for capital spend.

PROFILE

Allina Health System, doing business as Allina Health, is headquartered in Minneapolis. Allina owns and operates 10 hospitals and jointly owns and operates one other hospital, offering a full array of tertiary and quaternary services in Minnesota and western Wisconsin. Allina also operates multiple outpatient access sites and is co-owner of a Medicare Advantage and commercial plan with Aetna. Allina employs about 1,465 physicians that are either part of its physician network, Allina Health Group, or are hospital based.

METHODOLOGY

The principal methodology used in these ratings was Not-For-Profit Healthcare published in December 2018 and available at https://www.moodys.com/researchdocumentcontentpage.aspx?docid=PBM_1154632. Alternatively, please see the Rating Methodologies page on www.moodys.com for a copy of this methodology.

REGULATORY DISCLOSURES

For further specification of Moody's key rating assumptions and sensitivity analysis, see the sections Methodology Assumptions and Sensitivity to Assumptions in the disclosure form. Moody's Rating Symbols and Definitions can be found at: https://www.moodys.com/researchdocumentcontentpage.aspx?docid=PBC_79004.

For ratings issued on a program, series, category/class of debt or security this announcement provides certain regulatory disclosures in relation to each rating of a subsequently issued bond or note of the same series, category/class of debt, security or pursuant to a program for which the ratings are derived exclusively from existing ratings in accordance with Moody's rating practices. For ratings issued on a support provider, this announcement provides certain regulatory disclosures in relation to the credit rating action on the support provider and in relation to each particular credit rating action for securities that derive their credit ratings from the support provider's credit rating. For provisional ratings, this announcement provides certain regulatory disclosures in relation to the provisional rating assigned, and in relation to a definitive rating that may be assigned subsequent to the final issuance of the debt, in each case where the transaction structure and terms have not changed prior to the assignment of the definitive rating in a manner that would have affected the rating. For further information please see the ratings tab on the issuer/entity page for the respective issuer on www.moodys.com.

Regulatory disclosures contained in this press release apply to the credit rating and, if applicable, the related rating outlook or rating review.

Moody's general principles for assessing environmental, social and governance (ESG) risks in our credit analysis can be found at http://www.moodys.com/researchdocumentcontentpage.aspx?docid=PBC_1288235.

Please see www.moodys.com for any updates on changes to the lead rating analyst and to the Moody's legal entity that has issued the rating.

Please see the ratings tab on the issuer/entity page on www.moodys.com for additional regulatory disclosures for each credit rating.

Diana Lee
Lead Analyst
PF Healthcare
Moody's Investors Service, Inc.
7 World Trade Center
250 Greenwich Street
New York 10007
JOURNALISTS: 1 212 553 0376
Client Service: 1 212 553 1653

Daniel Steingart
Additional Contact
PF Healthcare
JOURNALISTS: 1 212 553 0376
Client Service: 1 212 553 1653

Releasing Office:
Moody's Investors Service, Inc.
250 Greenwich Street
New York, NY 10007
U.S.A
JOURNALISTS: 1 212 553 0376
Client Service: 1 212 553 1653

No Related Data.
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