11 health systems with strong finances

Here are 11 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 and are listed in alphabetical order.

1. Clearwater, Fla.-based BayCare Health System has an "Aa2" rating and stable outlook with Moody's. The health system has strong operating performance and favorable balance sheet metrics, according to Moody's. The credit rating agency expects the health system to maintain excellent liquidity and to move quickly with capital expansion. 

2. Cincinnati-based Bon Secours Mercy Health has an "AA-" rating and stable outlook with Fitch. The health system has a broad geographic footprint, a good payer mix and a strong financial profile, according to Fitch. The credit rating agency anticipates that Bon Secours Mercy Health will increase capital spending over the next three years due to strategic investments in its expanded markets.

3. Santa Barbara, Calif.-based Cottage Health has an "AA-" rating and stable outlook with Fitch. The health system has a leading market position and strong profitability and cash flow, according to Fitch. Going forward, the rating agency expects Cottage Health to see moderate revenue growth. 

4. Houston-based Harris Health System has an "Aa1" rating and stable outlook with Moody's. The health system has a stable financial profile, strong operating margins and healthy liquidity, according to Moody's. The credit rating agency expects Harris Health System, which is supported by a large and expanding tax base, to maintain a solid financial position.   

5. Honolulu-based Hawaii Pacific Health has an "AA-" rating and stable outlook with Fitch. The health system has a solid market position and healthy operating profitability, according to Fitch. The credit rating agency expects the health system to sustain continued capital and strategic investments without the need for incremental debt in the foreseeable future.

6. Dallas-based Methodist Health System has an "Aa3" rating and stable outlook with Moody's. The health system has healthy balance sheet measures and operating performance as well as favorable leverage metrics, according to Moody's. The credit rating agency expects Methodist Health System's expense control initiatives and revenue growth opportunities to continue to drive sustainable operating performance.

7. Evanston, Ill.-based NorthShore University HealthSystem has an "AA-" rating and stable outlook with S&P and an "Aa3" rating and stable outlook with Moody's. The health system has a strong balance sheet, good market presence and a management team that continues to execute its strategic plan, according to S&P. The rating agency expects NorthShore to maintain strong balance sheet metrics and low leverage.

8. Chicago-based Rush University System for Health has an "AA-" rating and stable outlook with Fitch. The health system has a broad reach for high-acuity services as a leading academic medical center and its operating risk profile is strong, according to Fitch. The credit rating agency expects Rush to maintain strong capital-related ratios over the next five years.

9. Stanford (Calif.) Health Care has an "Aa3" rating and stable outlook with Moody's. The health system has unique clinical offerings and a strong reputation for patient care and research, according to Moody's. The credit rating agency expects Stanford Health Care to maintain strong patient demand and grow absolute cash flow over the next several years.

10. Cincinnati-based TriHealth has an "AA-" rating and stable outlook with Fitch. The health system's operating risk profile is strong, and it is a market leader for commercially insured patients, according to Fitch. The credit rating agency expects TriHealth to sustain good operating ratios, which should lead to liquidity growth.

11. Madison, Wis.-based UW Health has an "Aa3" rating and stable outlook with Moody's. UW Health has healthy margins from a large and growing clinical footprint, according to Moody's. The rating agency expects UW Health's margins to remain strong.

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