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. Hospital and health system names were compiled from credit rating reports and are listed in alphabetical order.

1. Dover, Del.-based Bayhealth Medical Center has an "AA" rating and stable outlook with Fitch. The system, which includes two hospital campuses, has ample liquidity, strong operating results, light leverage and is the market leader in its service area, Fitch said. The credit rating agency expects Bayhealth Medical Center to sustain strong operating margins and maintain health liquidity, despite the pressure of the COVID-19 pandemic. 

2. Milwaukee-based Children's Hospital and Health System has an "Aa3" rating and stable outlook with Moody's. The health system has strong cash flow margins, broad reach across Wisconsin and a long track record of meeting budgets, Moody's said. The credit rating agency expects the system's financial performance to remain solid in spite of the impact from the COVID-19 pandemic. 

3. Edison, N.J.-based Hackensack Meridian Health has an "AA-" rating and stable outlook with Fitch and an "AA-" rating and stable outlook with S&P. The health system has a strong financial profile and a solid market position in a large service area, Fitch said. The credit rating agency expects the system to produce strong operating performance after the COVID-19 pandemic. 

4. Houston Methodist has an "AA" rating and stable outlook with S&P. The system, which comprises an academic medical center and six community hospitals, has a strong enterprise profile and a history of excellent margins and cash flow, S&P said. The credit rating agency said Houston Methodist is well positioned to withstand the pressures from COVID-19. 

5. Saint Joseph, Mo.-based Mosaic Health System has an "AA-" rating and stable outlook with Fitch. The health system is a market leader in a multicounty service area and has a track record of strong operating results, Fitch said. The credit rating agency expects Mosaic will sustain strong operating margins and maintain healthy liquidity and leverage metrics, despite the pressure of the COVID-19 pandemic. 

6. NewYork-Presbyterian has an "AA" rating and stable outlook with Fitch. NewYork-Presbyterian is a major regional academic system with strong operating margins, and it had a strong balance sheet heading into the COVID-19 pandemic, Fitch said. After a challenging 2020 and 2021, Fitch expects the health system's operating metrics to return to historical levels. 

7. Broomfield, Colo.-based SCL Health has an "AA-" rating and stable outlook with Fitch. The system has a track record of exceptional operations, consistent improvement in unrestricted liquidity levels and significant financial flexibility, Fitch said. The credit rating agency said SCL Health is well positioned to manage the pressures of COVID-19, having built up cash reserves.

8. Arlington-based Texas Health Resources has an "Aa2" rating and stable outlook with Moody's. The health system has a strong cash position and cash measures, Moody's said. The credit rating agency said the health system will likely recover from revenue declines in fiscal 2020 linked to the pandemic. 

9. Iowa City-based University of Iowa Hospitals and Clinics has an "Aa2" rating and stable outlook with Moody's. It is the only academic medical center in Iowa and has conservative balance sheet management and strong patient demand, Moody's said. The credit rating agency expects the health system to rebound to more normalized operating levels after challenges of the COVID-19 pandemic. 

10. Yale New Haven (Conn.) Health has an "AA-" rating and stable outlook with S&P, an "AA-" rating and stable outlook with Fitch and an "Aa3" rating and stable outlook with Moody's. The health system has a leading market position in Connecticut, strong brand recognition and historically strong operating cash flow margins, Moody's said. 

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