CHICAGO — The Sarah Bush Lincoln Health System, a small A-plus-rated provider in southern Illinois, began planning a $45 million bond issue early last fall. But after months of watching interest rates climb in the public market, the hospital decided to privately place the debt with a bank.

“In my career, I’ve never done a direct placement — it’s always been a public financing,” said vice president of finance Craig Sheagren, who has worked in health care finance for more than 35 years.

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