As health systems face tighter margins and rising capital costs, the traditional "sell-and-leaseback" model is being replaced by more nuanced, system-led financing strategies. We will dive into alternative lease financing, including Credit Tenant Leases (CTL), synthetic leases, and charitable models, leveraged by systems to optimize balance sheet impact. The panel will also feature a timely look at Energy Infrastructure Joint Ventures, a rapidly growing model used by systems to modernize facilities with zero upfront capital.
Learning objectives—At the end of the session, participants will be able to:
- Evaluate the Strategic Impetus for Reverse Monetization: Identify the key drivers—such as deferred maintenance, cost of capital and discount to replacement cost—behind the trend of health systems reacquiring medical outpatient buildings.
- Navigate Ground Lease Friction Points: Analyze current industry standards for purchase options, FAR considerations, and the impact of shortened ground lease durations on asset valuation.
- Differentiate Alternative Lease Models: Compare the mechanics and balance sheet implications of Credit Tenant Leases/Loans, synthetic leases, and foundation-led charitable lease models.
- Assess Energy Infrastructure JVs: Understand the structure and benefits of energy-focused joint ventures, including how they facilitate large-scale facility upgrades without impacting traditional debt capacity.
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