The Handbook of Municipal Bonds

CASE STUDY 12

Financings of the Medical University Hospital Authority of South Carolina

Joseph A. Spiak Managing Director UBS Securities LLC

 

 

 

The Medical University of South Carolina (MUSC) has served the citizens of South Carolina since 1824. MUSC has expanded from a small private medical college to a state university with an adult and children’s medical center and six colleges: Medicine, Pharmacy, Nursing, Graduate Studies, Dental, and Health Professions. For the past 183 years, MUSC has served as the principal teaching and research hospital for the people of South Carolina and has the distinction of being the oldest medical school in the South.

Over the years, since its founding, a number of institutions have served as the teaching hospital of MUSC. For a long period, Roper Hospital, a local not-for-profit hospital, served as the clinic teaching facility of the University. In 1955, through funding by the legislature of South Carolina and the Hill-Burton Program, The Medical University Hospital was built and serves in part today as the clinical teaching facility of MUSC. Operations of the hospital proceeded fairly well until the 1990s, when the pressure of reduced Medicare payments, growing Medicaid caseloads and increased indigent care brought about an economic concern at the hospital. Operating losses mounted and the future viability of the hospital was in question.

A debate began within the South Carolina Legislature, the hospital, MUSC, and the medical community on how ...