12 hospitals with strong finances

Here are 12 hospitals and health systems with strong operational metrics and solid financial positions, according to recent reports from Moody's Investors Service and Fitch Ratings.

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

1. St. Louis-based Ascension has an "Aa2" senior debt rating and stable outlook with Moody's. The health system has a large diversified portfolio of sizable hospitals and strong liquidity. Moody's expects Ascension's margins to improve in fiscal year 2019.

2. Prince Frederick, Md.-based CalvertHealth System has an "AA-" rating and stable outlook with Fitch. The system has a leading market share, a favorable payer mix and stable cash flow, according to Fitch.

3. Children's Healthcare of Atlanta has an "Aa2" rating and stable outlook with Moody's. The health system has a dominant market position, strong margins and ample liquidity, according to Moody's.

4. Cleveland Clinic has an "Aa2" rating and stable outlook with Moody's. Cleveland Clinic has strong brand recognition, exceptional fundraising ability and healthy cash flow, according to Moody's.

5. La Crosse, Wis.-based Gundersen Lutheran Medical Center has an "AA-" rating and stable outlook with Fitch. The hospital has a leading market position, solid balance sheet metrics and a favorable payer mix, according to Fitch.

6. Inova Health System has an "Aa2" rating and stable outlook with Moody's. The Falls Church, Va.-based health system has consistently strong cash-flow margins, a leading market position and a good investment position, according to Moody's.

7. Philadelphia-based Main Line Health has an "Aa3" rating and stable outlook with Moody's. The system has a strong market position, healthy balance sheet metrics and a light debt burden, according to Moody's.

8. Dallas-based Methodist Health System has an "Aa3" rating and stable outlook with Moody's. The health system has a favorable liquidity position, consistent operating results and a growing market population, according to Moody's.

9. Omaha-based Nebraska Medicine has an "AA-" rating and stable outlook with Fitch. The system has strong operating margins and a light debt burden, according to Fitch.

10. Sisters of Charity of Leavenworth (Kan.) Health System, which does business as SCL Health, has an "Aa3" rating and stable outlook with Moody's. The system has a good market position in a favorable service area, strong operating margins and limited capital spending, according to Moody's.

11. Houston-based Texas Children's Hospital has an "Aa2" rating and stable outlook with Moody's. The hospital has strong brand equity and is a national leader in pediatric services, which will continue to generate revenue growth, according to Moody's.

12. Chapel Hill-based University of North Carolina Hospitals has an "Aa3" rating and stable outlook with Moody's. The health system has an excellent market position, strong patient demand and healthy financial performance, according to Moody's.

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