10 health systems with strong finances

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

Note: This is not an exhaustive list. Health system names were compiled from recent credit rating reports and are listed in alphabetical order.

1. Hyannis, Mass.-based Cape Cod Healthcare has an "AA-" rating and stable outlook with Fitch. The health system has a dominant market position in its service area, solid operating results and a manageable capital plan, according to Fitch.

2. Dallas-based Children's Health System of Texas has an "Aa2" rating and stable outlook with Moody's. The health system has strong liquidity, a leading market position, and low operating lease and pension obligations, according to Moody's.

3. Indianapolis-based Indiana University Health has an "Aa2" rating and stable outlook with Moody's. The health system has a strong regional market position and solid margins and liquidity, according to Moody's.

4. Falls Church, Va.-based Inova Health System has an "Aa2" rating and stable outlook with Moody's. The health system has a leading market position in the broader northern Virginia region and strong operating cash flow margins, according to Moody's.

5. Oakland, Calif.-based Kaiser Permanente has an "AA-" rating and stable outlook with Fitch and S&P. Kaiser has a robust integrated business model, strong operational cash flow and ample unrestricted reserves, according to S&P.

6. Winston-Salem, N.C.-based Novant Health has an "AA-" rating and stable outlook with Fitch and S&P. The health system has consistent healthy operating performance and a falling debt load, according to S&P.

7. Renton, Wash.-based Providence St. Joseph Health has an "Aa3" rating and stable outlook with Moody's and an "AA-" rating and stable outlook with Fitch. The health system has a large service area, a revenue base of more than $24 billion and an integrated care delivery platform, which includes health plans, employed physicians and inpatient and outpatient services, according to Moody's.

8. San Diego-based Scripps Health has an "Aa3" rating and stable outlook with Moody's. The health system has strong market share within San Diego County, a history of strong and stable management, and favorable balance sheet measures, according to Moody's.

9. Sacramento, Calif.-based Sutter Health has an "Aa3" rating and stable outlook with Moody's. The health system has a strong presence in Northern California and a conservative asset-liability structure, according to Moody's.

10. Yale New Haven (Conn.) Health has an "Aa3" rating and stable outlook with Moody's. The health system has strong brand recognition, solid liquidity and a leading market position in Connecticut, according to Moody's.

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