13 health systems with strong finances

Here are 13 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. Minneapolis-based Allina Health has an "AA-" rating and stable outlook with Fitch and an "Aa3" rating and stable outlook with Moody's. The health system has a strong financial profile and a leading market position in the Twin Cities metro area, according to Fitch.

2. Phoenix-based Banner Health has an "AA-" rating and stable outlook with Fitch. The system has a strong financial profile and a significant presence in six western states, according to Fitch. The credit rating agency expects Banner's gradual improvements to operating margins will continue to support capital spending levels and liquidity growth.

3. Cleveland Clinic Health System has an "Aa2" rating and stable outlook with Moody's. The health system's strength as an international brand will allow it to grow revenue outside of the constrained northeast Ohio market, and its exceptional fundraising capabilities and cash flow will fund increasing capital spending, according to Moody's.

4. Mishawaka, Ind.-based Franciscan Alliance has an "Aa3" rating and stable outlook with Moody's. The health system has leading positions in key markets and a strong cash position, according to Moody's.

5. Milwaukee-based Froedtert Health has an "AA-" rating and stable outlook with Fitch. The system has consistently improved year-over-year market share and has a strong financial profile, according to Fitch.

6. Woodbury, N.J.-based Inspira Health Network has an "AA-" rating and stable outlook with Fitch. The health system maintained strong operating margins during a major construction project and IT implementation, and Fitch expects the system's strong operating performance to continue.

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

8. St. Joseph, Mo.-based Mosaic Life Care has an "AA-" rating and stable outlook with Fitch. The health system has a dominant market position and strong operating performance, according to Fitch.

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

10. Renton, Wash.-based Providence St. Joseph Health has an "AA-" rating and stable outlook with Fitch. Providence is the leading acute care provider in multiple markets with strong economic growth characteristics, which insulates the system from competition, according to Fitch.

11. San Diego-based Sharp HealthCare has an "Aa3" rating and stable outlook with Moody's. The health system has strong balance sheet measures and its market share continues to grow, according to Moody's.

12. Stanford (Calif.) Health Care has an "Aa3" rating and stable outlook with Moody's. The credit rating agency expects Stanford Health Care to continue to leverage its strong market position and brand name to generate stable margins and grow cash flow.

13. 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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