Here are 22 health systems with strong operational metrics and solid financial positions, according to reports from credit rating agencies Fitch Ratings and Moody’s Investors Service released in 2026.
Note: This is not an exhaustive list. Health systems were compiled from credit rating reports.
BJC Health has an “Aa2” rating and stable outlook with Moody’s. The St. Louis-based system’s scale and geographic diversification have been enhanced by its ongoing integration of Kansas City, Mo.-based Saint Luke’s Health System, Moody’s said. The completion of a new patient tower further strengthens BJC’s clinical platform, expands capacity and supports long-term strategic positioning.
CentraCare has an “AA-” rating and stable outlook with Fitch. The St. Cloud, Minn.-based system is expected to sustain strong capital-related ratios despite escalating labor costs and inflationary pressures, Fitch said.
Children’s Mercy has an “Aa2” rating and stable outlook with Moody’s. The rating reflects the Kansas City, Mo.-based system’s strong regional importance, high-acuity services and dominant market position.
ChristianaCare has an “Aa2” rating and stable outlook with Moody’s. The rating is supported by the Newark, Del.-based system’s role as Delaware’s largest teaching hospital, extensive clinical depth that affords strong regional and statewide market capture and growing demand, Moody’s said.
Cleveland Clinic has an “Aa2” rating and stable outlook with Moody’s. The rating reflects the system’s international brand in advanced clinical care and research, as well as centralized governance, which supports strong patient demand and durable operating improvement, Moody’s said.
Cook Children’s Health Care System has an “Aa2” rating and positive outlook with Moody’s. The Fort Worth, Texas-based system is a leading pediatric provider anchored by dominant regional demand and a broad, high-acuity clinical platform, Moody’s said.
FirstHealth of the Carolinas has an “AA-” rating and stable outlook with Fitch. The Pinehurst, N.C.-based system has a strong market presence and minimal competition and is supported by steady operating metrics and strategic investments in demographically favorable markets.
Houston Methodist has an “AA” rating and stable outlook with Fitch. The system’s favorable service area demographics and a high case index — particularly at its flagship campus in the Texas Medical Center — align with the system’s complex care positioning and strong institutional characteristics, Fitch said.
McLaren HealthCare has an “AA-” rating and stable outlook with Fitch. The Grand Blanc, Mich.-based system benefits from scale and revenue diversity, including health plan and hospital operations, an ambulatory network and Michigan’s largest cancer network, Fitch said.
Med Center Health has an “AA-” rating and positive outlook with Fitch. The Bowling Green, Ky.-based system has sustained operating profitability and strong cash flow generation, aided by revenue support from Kentucky’s Hospital Rate Improvement Program, Fitch said.
Methodist Health System has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the Dallas-based system’s strong operating performance and excellent liquidity, which are supported by a favorable demographic backdrop in the Dallas-Fort Worth-Arlington metropolitan area, Moody’s said.
Midland (Texas) Health has an “AA-” rating and stable outlook with Fitch. Midland has a leading market position with limited competition for acute care services, as well as historically strong operating performance, Fitch said.
Monument Health has a “AA-” rating and stable outlook with Fitch. The Rapid City, S.D.-based system has a dominant inpatient market position as the leading acute care provider in its geographically broad service area, Fitch said. The system has made meaningful strides in improving its operating performance over the past two years.
Rady Children’s Health has an “AA” rating and stable outlook with Fitch. The rating reflects the San Diego-based system’s robust market position as the high-acuity provider of pediatric services throughout Southern California, its expanded two-campus platform following its merger with Orange, Calif.-based Children’s Hospital of Orange County, and strong financial profile, Fitch said.
Salem (Ore.) Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the system’s dominant market position in a good service area with solid demand for acute care services, Fitch said.
Sarasota (Fla.) Memorial Health Care System has an “AA-” rating and stable outlook with Fitch. The rating reflects the system’s leading market position in a growing area, along with robust operating cash flow and ample liquidity, Fitch said.
Seattle Children’s Hospital has an “AA” rating and stable outlook with Fitch. The rating reflects the system’s market position as the leading provider of high-quality pediatric care across a four-state service area, Fitch said. It also reflects its relationship with the Seattle-based University of Washington School of Medicine and substantial research capabilities.
St. Elizabeth Medical Center has an “AA” rating and stable outlook with Fitch. The Edgewood, Ky.-based system holds a commanding 83% share of inpatient volume in its primary service area, Fitch said.
UCHealth has an “AA+” rating and stable outlook with Fitch. The Aurora, Colo.-based system has a very strong financial profile, benefiting from its market position in a growing service area and a long track record of robust operating margins.
University of Kansas Health System has an “AA-” rating and stable outlook with Fitch. The rating reflects the Kansas City-based system’s improving operational results, which are supported by strong demand and expanding scale following the acquisition of Liberty (Mo.) Hospital and Olathe (Kan.) Health.
University of North Carolina Health Care System has an “Aa2” rating and stable outlook with Moody’s. The rating reflects the Chapel Hill, N.C.-based system’s strong overall financial performance, which is underpinned by its reputation as a major academic medical center, ownership ties to the state of North Carolina and key role in statewide healthcare.
Willis-Knighton Medical Center has an “AA-” rating and positive outlook with Fitch. The Shreveport, La.-based system has a dominant inpatient market position and strong volume growth, Fitch said. Its operating and financial metrics are on track to support a higher rating near term.
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