Healthcare Private Credit
CoreHealth is named for its mandate: the non-discretionary core of healthcare, where demand is essential rather than elective, cash flows are predictable and reimbursement-anchored, performance holds through cycles, and durable barriers to entry protect position. Every subsector is tested against this framework before it receives our capital.
Healthcare demand is driven by demographics, acuity, and aging, independent of the economic environment. The leading edge of the Baby Boom turns 80 in 2026 with a decade of rising population behind it, the 65 and over population will grow 42% to 82 million by 2050, and utilization of skilled nursing and post-acute care accelerates sharply after age 75. Our borrowers deliver services their patients cannot defer.
Our borrowers’ revenues are paid predominantly by Medicare, Medicaid, and investment-grade commercial insurers, government and rated counterparties with published rates and established payment cycles. That payor structure produces recurring, defensible cash flows that can be underwritten with precision and monitored in real time.
When real GDP contracted 4.3% in the 2007 to 2009 recession, healthcare spending grew 4.0% in 2009. The sector has expanded through every downturn in modern history because its demand drivers are demographic, not cyclical. We underwrite for downside first.
Three lending products, one mandate. Real estate, asset-based, and cash flow lending for middle market healthcare, matched to how each business generates value, not forced into a single structure.
First-lien loans on healthcare real estate assets: skilled nursing, seniors housing, and medical office buildings. Stable cash flows underpinned by Medicare and Medicaid reimbursement and strong demographic tailwinds.
Revolving credit facilities secured by healthcare accounts receivable. Not-for-profit hospitals, skilled nursing operators, specialty pharmacy distributors, healthcare staffing, and medical distributors. Investment-grade counterparty risk.
Senior secured, first-lien term loans to healthcare services companies with recurring, defensible EBITDA. Home health, hospice, IDD, dental, behavioral health, physician practice management, and pharma services.
Senior secured, first lien only.
Healthcare is the largest segment of the U.S. economy at $5.3 trillion, or 18% of GDP. Spending is projected to grow 5.4% annually through 2034 versus 4.1% for GDP, and the sector remains underserved by dedicated credit providers.
Since 2000, the 85 and over population has grown roughly 60% while the supply of skilled nursing beds has declined 12%. Certificate of Need and moratorium laws restrict new beds in more than 40 states, so demand compounds against a fixed asset base.
State and federal regulatory complexity, specialized clinical knowledge, and long relationship development cycles limit effective competition to a handful of dedicated lenders in most subsectors.
Counterparty risk sits with rated payors: Medicare, Medicaid, and commercial insurers. State and federal governments have raised rates consistently over the past decade. CMS finalized a 2.4% net increase to skilled nursing Medicare rates for FY2027, effective October 1, 2026.¹
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info@corehealthcf.com