5 hospitals with strong finances

Here are five hospitals and health systems with strong operational metrics and solid financial positions based on recent reports from Standard & Poor's Rating Service, Moody's Investors Service and Fitch Ratings.

1. Sacramento, Calif.-based Sutter Health has an "Aa3" rating and stable outlook with Moody's. The system has a strong presence in northern California and a history of strong cash flows. Sutter's operating performance improved in fiscal year 2014 after a challenging FY 2013.

2. Philadelphia-based Maine Line Health System has an "Aa3" rating and a positive outlook with Moody's. The system has a strong balance sheet and a leading market position in a demographically attractive primary service area.

3. Spartanburg (S.C.) Regional Health System has an "A+" rating and a stable outlook with Fitch. The system has a manageable debt burden, and it is the sole tertiary provider in Spartanburg County.

4. Wauwatosa, Wis.-based Children's Hospital and Health System has an "Aa3" rating and a stable outlook with Moody's. The system has a strong market position, a modest debt load and an improving balance sheet.

5. Sioux Falls, S.D.-based Sanford Health has an "A+" rating and stable outlook with S&P. The system has a strong business position and benefits from a largely all employed physician staff. Sanford Health also had dramatically higher earnings and cash flow in FY 2015 than the year prior.

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