Here are 87 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 2025.
Note: This is not an exhaustive list. Health systems were compiled from credit rating reports.
AdventHealth has an “AA” rating and stable outlook with Fitch. The Altamonte Springs, Fla.-based system has a sizable market presence across nine states and an “exceptional financial profile” characterized by a history of strong operating results, Fitch said.
Advocate Health’s member organizations Advocate Aurora Health and Atrium Health have “Aa2” ratings and stable outlooks with Moody’s. The Charlotte, N.C.-based system has significant scale, strong market share in major metropolitan areas and solid financial performance and liquidity, Moody’s said.
Akron (Ohio) Children’s Hospital has an “AA-” rating and stable outlook with Fitch. Akron Children’s has a consistently strong operating performance and very strong liquidity, Fitch said.
Ann & Robert H. Lurie Children’s Hospital of Chicago has an “AA” rating and stable outlook with Fitch. The rating is supported by its strong balance sheet with lower leverage ratios from modest debt, Fitch said.
Ascension has an “AA” rating and stable outlook with Fitch. The St. Louis-based system has unique credit features found in only a few health systems, such as national size and scale and a significant presence in key growing markets Texas, Florida, Tennessee and Indiana, Fitch said.
AtlantiCare has an “AA-” rating and stable outlook with Fitch. The rating reflects the Atlantic City, N.J.-based system’s strong balance sheet, a leading market share and Fitch’s view that operating performance will continue to rebound and stabilize.
Atlantic Health System has an “Aa3” rating and stable outlook with Moody’s. The Morristown, N.J.-based system’s economically favorable service areas and its focus on outpatient care and clinical partnerships support solid demand trends and good revenue trends, Moody’s said.
Avera Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the Sioux Falls, S.D.-based system’s strong operating risk and financial profile assessment, Fitch said. The system has significant size and scale in the Sioux Falls market and the four other states where its facilities are located.
Banner Health has an “AA-” rating and stable outlook with Fitch. The rating highlights the strength of the Phoenix-based system’s core hospital delivery system and the diversification of its insurance division, Fitch said.
Baptist Health has an “AA” rating and stable outlook with Fitch. The Jacksonville, Fla.-based system’s rating reflects good market demographics, strong organic top line revenue growth and specialized care, Fitch said.
Baptist Health South Florida has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the Coral Gables-based system’s position as the largest system in south Florida and leading share in attractive markets, Moody’s said.
Bayhealth has an “AA” rating and stable outlook with Fitch. The rating reflects the Dover, Del.-based system’s market position and the stability of its financial profile.
Baylor Scott & White Health has an “Aa2” rating and stable outlook with Moody’s. The Dallas-based system has consistently strong financial performance, driven by “deep and disciplined leadership” and favorable demographic characteristics, Moody’s said.
Berkshire Health System has an “AA-” rating and stable outlook with Fitch. The rating is primarily based on the Pittsfield, Mass.-based system’s strong financial profile given its solid liquidity and modest leverage, Fitch said.
Billings Clinic-Logan Health has an “AA-” rating and stable outlook with Fitch. The system — which was formed by the September 2023 merger of Billings (Mont.) Clinic and Kalispell, Mont.-based Logan Health — is the largest health system in Montana and is supported by a track record of good operating metrics, Fitch said.
BJC HealthCare has an “Aa2” rating and stable outlook with Moody’s. The rating reflects the St. Louis-based system’s prominent reputation as a leading academic medical center with a long-standing affiliation with Washington University School of Medicine, Moody’s said. Its scale and geographic presence were enhanced through its January 2023 acquisition of Kansas City, Mo.-based Saint Luke’s Health System.
Bon Secours Mercy Health has an “AA-” rating and stable outlook with Fitch. The Cincinnati-based system’s rating reflects its broad geographic footprint and status as the fifth-largest Catholic health system in the U.S. and largest private health system in the Republic of Ireland.
Boston Children’s Hospital has an “Aa2” rating and stable outlook with Moody’s. The rating reflects the system’s reputations as a top children’s hospital in the U.S., with recognition as a leading pediatric research institution, which continues to anchor the credit profile, Moody’s said.
Cape Cod (Mass.) Healthcare has an “AA-” rating and stable outlook with Fitch. The rating is supported by the system’s dominant market share, sizable investments in specialty service lines and extensive history of strong operating results, Fitch said.
Carle Health has an “AA-” rating and stable outlook with Fitch. The Urbana, Ill.-based system has a distinctly leading market position across a broad service area, and Fitch expects the system will sustain its strong capital-related ratios.
CaroMont Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the Gastonia, N.C.-based system’s leading local market position, strong financial profile and good operating performance, Fitch said.
Cedars-Sinai has an “Aa3” rating and stable outlook with Moody’s. The rating is supported by the Los Angeles-based system’s leading position in its metro area in both primary care and subspecialties, backed by its strong reputation for clinical care and research, Moody’s said.
CentraCare has an “AA-” rating and stable outlook with Fitch. The rating reflects the St. Cloud, Minn.-based system’s leading market position over a broad service area, Fitch said.
Children’s Healthcare of Atlanta has an “Aa1” rating and stable outlook with Moody’s. The rating is supported by the system’s expansive reach in delivering tertiary and quaternary pediatric care across Georgia, which is reinforced by its strong brand reputation and affiliation with Atlanta-based Emory University, Moody’s said.
Children’s Hospital of Alabama has an “AA-” rating and stable outlook with Fitch. The Birmingham-based system’s financial profile provides flexibility to navigate future changes in Medicaid reimbursement and to address its future capital spending, Fitch said.
Children’s Hospital Colorado has an “Aa3” rating and stable outlook with Moody’s. The rating is supported by the Aurora-based system’s superior clinical offerings, which place it among the top children’s hospitals in the nation, Moody’s said.
Children’s Minnesota has an “AA” rating and stable outlook with Fitch. The Minneapolis-based system’s rating reflects Fitch’s expectation of a marginal operating improvement over the next two to three years as it begins an EHR conversion project while focusing on operating efficiencies and key service line growth.
Children’s Nebraska has an “AA-” rating and positive outlook with Fitch. The Omaha-based system has a dominant market position as the only comprehensive pediatric provider and the successful integration of its Hubbard Center for Children tower project has resulted in a year-over-year increase in volumes.
Concord (N.H.) Hospital has an “AA-” rating and stable outlook with Fitch. The rating reflects a strong balance sheet, dominant market share, good payer mix and volume growth, Fitch said.
Cone Health has an “AA-” rating and stable outlook with Fitch. The Greensboro, N.C.-based system was acquired by Kaiser Permanente’s Risant Health in December. Cone’s rating is equal to Oakland, Calif.-based Kaiser’s, whose rating is driven by its very strong financial profile, bolstered by a very large and diversified revenue base, Fitch said.
Cook Children’s Medical Center has an “Aa2” rating and stable outlook with Moody’s. The rating reflects the Fort Worth, Texas-based system’s excellent market position as Tarrant County’s only pediatric provider, which drives high demand and revenue growth, Moody’s said.
Corewell Health has an “Aa3” rating and stable outlook with Moody’s. The system — based in Grand Rapids and Southfield, Mich. — has a substantial presence as a provider and payer in Michigan, underscored by its consistent financial performance and solid liquidity, Moody’s said.
Cottage Health has an “AA-” rating and stable outlook with Fitch. The rating reflects that the Santa Barbara, Calif.-based system is expanding its geographic reach with a network of outpatient facilities that Fitch believes will continue to improve access to care and solidify the system’s leading market position.
Deaconess Health System has an “AA” rating and stable outlook with Fitch. The Evansville, Ind.-based system has demonstrated operating cost flexibility during a period of high growth as it executes on its regional hub strategy, Fitch said.
Doylestown (Pa.) Health has an “Aa3” rating and stable outlook with Fitch. The upgrade reflects that its obligations are now on par with Philadelphia-based Penn Medicine’s other debt. Penn acquired Doylestown Health in April.
Duke University Health System has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the Durham, N.C.-based system’s clinical excellence and its likelihood of meeting its forecasted fiscal 2025 operating performance, Moody’s said.
El Camino Health has an “AA” rating and stable outlook with Fitch. The rating reflects Fitch’s expectation that the Mountain View, Calif.-based system will continue to deliver strong operating performance over the medium term, partly due to management’s effective expense management practices and strategic initiatives aimed at growing top-line revenue.
FirstHealth of the Carolinas has an “AA” rating and stable outlook with Fitch. The rating reflects the Pinehurst, N.C.-based system’s strong market presence and minimal competition, backed by steady operating metrics, Fitch said.
Franciscan Health has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the Mishawaka, Ind.-based system’s geographic diversity, leading positions in key markets and strong liquidity, Moody’s said.
Froedtert ThedaCare Health has an “AA” rating and stable outlook with Fitch. The Milwaukee-based system has a broad market position as a leading academic medical center and a track record of strong utilization and operations, Fitch said.
Gundersen Health System has an “AA-” rating and stable outlook with Fitch. The rating reflects the La Crosse, Wis.-based system’s strong balance sheet metrics, with high levels of liquidity and low debt burden, Fitch said.
Hawai’i Pacific Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the Honolulu-based system’s strong market position in the state, stable payer mix and Fitch’s expectation of improved operating performance in fiscal 2026.
Hoag Memorial Hospital Presbyterian has an “AA” rating and stable outlook with Fitch. The Newport Beach, Calif.-based system’s rating is supported by a leading market position in its immediate service area and strong financial profile, Fitch said.
Inspira Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the Vineland, N.J.-based system’s leading market position in a stable service area and large medical staff supported by a growing residency program.
Johns Hopkins Health System has an “AA-” rating and stable outlook with Fitch. The rating reflects the Baltimore-based system’s robust financial profile and enduring market position, underpinned by its highly regarded reputation with a national and international draw, Fitch said.
JPS Health Network has an “AA” rating and stable outlook with Fitch. The Fort Worth, Texas-based system’s rating reflects its significant taxing authority to compensate for a constrained payer mix, Fitch said.
Kaiser Permanente has an “AA-” rating and stable outlook with Fitch. The Oakland, Calif.-based system’s rating reflects a strong financial profile that is bolstered by a large and diversified revenue base, Fitch said. Kaiser is the most fully integrated health system in the U.S. and the largest nonprofit organization by revenue in the country.
Main Line Health has an “AA-” rating and stable outlook with Fitch. The Bryn Mawr, Pa.-based system has seen consistent operating performance over the past two years and has a strong market position in a favorable service area, Fitch said.
Mass General Brigham has an “Aa3” rating and stable outlook with Moody’s. The outstanding reputation of the Somerville, Mass.-based system’s flagship medical centers is bolstered by a significant investment program and a long-standing donor base that supports research, capital projects and various initiatives, Moody’s said.
McLaren Health Care has an “AA-” rating and stable outlook with Fitch. The rating reflects the Grand Blanc, Mich.-based system’s leading market position over a broad service area that covers much of the state, Fitch said. The system also sustained its track record of profitability despite the COVID-19 pandemic, subsequent labor and inflationary pressures, and a cyberattack.
Med Center Health has an “AA-” rating and stable outlook with Fitch. The Bowling Green, Ky.-based system’s rating is supported by solid operating performance in fiscal 2024 and through the first six months of fiscal 2025, Fitch said.
Memorial Sloan-Kettering Cancer Center has an “AA” rating and stable outlook with Fitch. The rating reflects Fitch’s expectation that the New York City-based organization will maintain its reputation as a premier cancer hospital, which will continue to support its leading and growing market share for its specialty services.
Monument Health has an “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.
Mosaic Life Care has an “AA” rating and stable outlook with Fitch. The rating reflects the St. Joseph, Mo.-based system’s leading market position and recovering operating performance, Fitch said.
Munson Healthcare has an “AA” rating and stable outlook with Fitch. The rating reflects the Traverse City, Mich.-based system’s leading market position and its very strong leverage and liquidity profiles.
MyMichigan Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the Midland, Mich.-based system’s market position as the largest provider of acute care services in a sizable geographic area covering 26 counties in the state, Fitch said.
NewYork-Presbyterian has an “AA” rating and stable outlook with Fitch. The New York City-based system’s rating is supported by its market position as one of New York’s premier academic healthcare systems, with a strong reputation that extends beyond the region, Fitch said.
Nationwide Children’s Hospital has an “AA” rating and stable outlook with Fitch. The Columbus, Ohio-based system is supported by its nationally recognized pediatric brand, dominant market position and strong balance sheet metrics.
Novant Health has an “AA-” rating and stable outlook with Fitch. The rating reflects Fitch’s expectation that the Winston-Salem, N.C.-based system will maintain operating EBITDA margins above 10%, as a growth period continues — both through acquisitions and capital spending — and it steadily deleverages from a $2.4 billion debt issuance in 2024, Fitch said.
OhioHealth has an “AA+” rating and stable outlook with Fitch. The Columbus-based system has an “exceptionally strong” credit profile with more than $6.1 billion in liquid funds and consistently very strong operating cash flow, Fitch said.
Orlando (Fla.) Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the system’s very strong and consistent operating performance and a growing presence in demographically favorable markets, Fitch said.
Parkland Health has an “AA-” rating and stable outlook with Fitch. The rating reflects Fitch’s expectation that the Dallas-based system will remain a leading safety-net provider in its service area, supported by its “expansive” tax levy.
Piedmont Healthcare has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the Atlanta-based system’s strong brand and extensive statewide presence, supported by leadership’s integration of several acquisitions in recent years and the growth of its clinically integrated physician network, Moody’s said.
Rush System for Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the Chicago-based system’s strong financial profile and Fitch’s expectation that operating margins will rebound despite ongoing macro labor pressures.
Saint Francis Healthcare System has an “AA” rating and stable outlook with Fitch. The rating reflects the Cape Girardeau, Mo.-based system’s strong financial profile, which Fitch said is characterized by robust debt and liquidity metrics, and sound debt service coverage.
Sanford Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the Sioux Falls, S.D.-based system’s leading inpatient market share across multiple regions, favorable payer mix, significant revenue diversification and expanded presence in Wisconsin following its merger with Marshfield (Wis.) Clinic Health System.
Sarasota (Fla.) Memorial Health Care System has an “AA-” rating and stable outlook with Fitch. The rating reflects the health system’s leading market position in a growing service area, robust historical operating cash flow levels and strong liquidity position, Fitch said.
Scripps Health has an “AA” rating and stable outlook with Fitch. The rating reflects Fitch’s view of the San Diego-based system’s strong market position in a favorable service area, good payer mix characteristics and strong unrestricted balance sheet resources.
Sharp HealthCare has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the San Diego-based system’s position as the leading provider in its county, with strong clinical offerings, an integrated health plan, extensive physician relationships and a history of well-executed strategies, Moody’s said.
St. Clair Hospital has an “AA-” rating and stable outlook with Fitch. The Pittsburgh-based system has seen steady improvement in operating performance over the past two fiscal years, and Fitch expects continued incremental performance over the near term.
Stanford Health Care has an “AA” rating and stable outlook with Fitch. The rating is supported by the Palo Alto, Calif.-based system’s extensive clinical reach in the greater San Francisco and Central Valley regions, and its role as a nationwide and worldwide destination for very high acuity services, Fitch said.
Sutter Health has an “AA-” rating and stable outlook with Fitch. The rating is supported by the Sacramento, Calif.-based system’s consistently strong growth across the organization, resulting in an expanded and strengthened care delivery network with solid market positions across all markets, Fitch said.
Texas Children’s Hospital has an “AA-” rating and stable outlook with Fitch. The rating reflects the Houston-based organization’s distinct leadership in pediatric care, strong balance sheet metrics, and steady recovery in operating performance, Fitch said. Operating results were challenged during fiscal 2024, but have seen a “marked turnaround” in 2025.
Trinity Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the Livonia, Mich.-based system’s national size and scale, with a significant market presence in multiple states, which is enhanced by its integrated delivery model, Fitch said.
UAB Health has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the Birmingham, Ala.-based system’s role as a leading medical center and its reputation as a top-tier research and clinical institution, Moody’s said.
UChicago Medicine has an “AA-” rating and stable outlook with Fitch. The system has a broad and growing reach for high-acuity services throughout the Chicago metro area and into Northwest Indiana, Fitch said.
UnityPoint Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the fully integrated, West Des Moines, Iowa-based system’s broad patient care platform and service line strategy, as well as strong leverage metrics, Fitch said.
University of Colorado Health has an “AA” rating and positive outlook with Fitch. The rating reflects the Aurora-based system’s strong financial profile — benefiting from its improving market position in a growth market and state — and long track-record of delivering robust operating margins, Fitch said.
University of Kansas Health System has an “AA-” rating and stable outlook with Fitch. The Kansas City-based system substantially increased its top line revenues with the acquisitions of Olathe (Kan.) Health and Liberty (Mo.) Hospital in recent years, Fitch said. Its flagship hospital is Kansas’ only academic medical center and is a major provider of high-end and unique services to a large geographic service area.
University of Pennsylvania Health System has an “Aa3” rating and stable outlook with Moody’s. The Philadelphia-based system’s investments in ambulatory expansion and high-acuity services will drive volumes and support a strong market position in a growing geographical area, Moody’s said.
Valley Health System has an “AA-” rating and stable outlook with Fitch. The Paramus, N.J.-based system has a strong payer mix — including its lower levels of Medicaid relative to peers — and its operating profile positions the system well to manage the upcoming financial effects of the recently passed One Big Beautiful Bill Act.
Virtua Health has an “AA” rating and stable outlook with Fitch. The Marlton, N.J.-based system’s rating is supported by its leading market position in a stable service area and continued outpatient expansion, Fitch said.
VCU Health has an “Aa3” rating and stable outlook with Moody’s. The Richmond, Va.-based system is one of the leading academic medical centers in its state and has an essential role as Virginia’s largest safety-net provider, Moody’s said.
VHC Health has an “AA-” rating and stable outlook with Fitch. The rating reflects Fitch’s expectation that the Arlington, Va.-based system’s ongoing strategic capital investment will drive operating improvement over the medium term as incremental revenue begins to offset costs associated with ramping up the outpatient pavilion and phased inpatient expansion and renovation.
Wake Forest Baptist has an “Aa3” rating and stable outlook with Moody’s. The Winston-Salem, N.C.-based system’s rating reflects its solid market position, its status as an academic medical center, and its membership in Advocate Health, Moody’s said.
WellSpan Health has an “Aa3” rating and stable outlook with Moody’s. The York, Pa.-based system’s rating reflects its scale and geographic reach, which underpin its leading market position across several contiguous counties in central Pennsylvania, Moody’s said.
Willis-Knighton Health System has an “AA-” rating and positive outlook with Fitch. The Shreveport, La.-based system’s rating reflects improved operating performance over the past few years, which Fitch expects will continue in 2025 and beyond.
