10 health systems with strong finances

Here are 10 health systems with strong operational metrics and solid financial positions, according to reports from Fitch Ratings, Moody's Investors Service and S&P Global Ratings.

Note: This is not an exhaustive list. Health system names were compiled from credit rating reports.

1. Gastonia, N.C.-based CaroMont Health has an "AA-" rating and stable outlook with Fitch. The health system has robust liquidity levels and a modest debt burden, Fitch said. The credit rating agency said it expects CaroMont Health to have the cushion to absorb escalating operating expenses and costs from staffing and expansions. 

2. Cedars-Sinai Health System has an "Aa3" rating and stable outlook with Moody's and an "AA-" rating and stable outlook with S&P. The Los Angeles-based health system has an excellent reputation for clinical services and a strong balance sheet, Moody's said. The credit rating agency said it expects Cedars-Sinai to successfully integrate Huntington Hospital in Pasadena, Calif., and improve that hospital's financial performance. 

3. Hackensack Meridian Health has an "AA-" rating and stable outlook with S&P. The Edison, N.J.-based health system has a healthy market position and a sound enterprise profile, including management's historically successful strategic decision making and execution, S&P said. 

4. Bryn Mawr, Pa.-based Main Line Health has an "AA" rating and stable outlook with Fitch. The health system has a leading market position in a favorable service area, and management has a strong track record of producing solid operating results, Fitch said. The credit rating agency said it expects Main Line Health's financial cushion to absorb sector pressures. 

5. Mass General Brigham has an "Aa3" rating and stable outlook with Moody's. The Boston-based health system has an excellent clinical reputation, good financial performance and strong balance sheet metrics, Moody's said. The credit rating agency said it expects Mass General Brigham to maintain a strong market position and stable financial performance. 

6. Methodist Health System has an "Aa3" rating and stable outlook with Moody's. The Dallas-based system has strong operating performance, and investments in facilities have allowed it to continue to capture more market share in the fast-growing Dallas-Fort Worth, Texas, area, Moody's said. The credit rating agency said it expects Methodist Health System's strong operating performance and favorable liquidity to continue. 

7. Albuquerque, N.M.-based Presbyterian Healthcare Services has an "Aa3" rating and stable outlook with Moody's and an "AA" rating and stable outlook with Fitch. The health system has a leading statewide market share, strong revenue growth and a healthy balance sheet, Moody's said. The credit rating agency said it expects Presbyterian Healthcare Services' operations to continue to improve and its balance sheet and debt metrics to remain strong. 

8. ThedaCare has an "AA-" rating and stable outlook with Fitch. The Neenah, Wis.-based health system has a leading market position and a strong financial profile, Fitch said. The credit rating agency said it expects ThedaCare's operating performance to remain stable through the disruption of the COVID-19 pandemic. 

9. Livonia, Mich.-based Trinity Health has an "AA-" rating and stable outlook with S&P. The health system's rating reflects its significant size, scale and geographic diversity in 25 states, S&P said. The credit rating agency said Trinity Health's management team has taken several actions to optimize its clinical portfolio and corporate functions for improved financial performance. 

10. University of Iowa Hospitals and Clinics has an "Aa2" rating and stable outlook with Moody's. The Iowa City-based health system, the only academic medical center in Iowa, has strong patient demand and excellent financial management, Moody's said. The credit rating agency said it expects the health system to continue to manage the pandemic with improved operating cash flow margins.

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