Below are 67 financial benchmarks, including key ratios for health systems, as well as revenue and margin metrics, broken down by rating category.
Key balance sheet metrics, ratios:
Source: Fitch Ratings’ “2021 Median Ratios: Not-for-Profit Hospitals and Healthcare Systems” report. It was released Aug. 3.
1. Cash on hand: 255 days
2. Accounts receivable: 44.6 days
3. Cushion ratio: 29x
4. Current liabilities: 95 days
5. Cash to debt: 169.9 percent
6. Cash to adjusted debt: 161.1 percent
7. Operating margin: 1.3 percent
8. Operating EBITDA margin: 6.7 percent
9. Excess margin: 3.1 percent
10. EBITDA margin: 8.5 percent
11. Net adjusted debt to adjusted EBITDA: -2.6 percent
12. Personnel costs as percent of total operating revenue: 55 percent
13. EBITDA debt service coverage: 3.9x
14. Operating EBITDA debt service coverage: 3.2x
15. Maximum annual debt service as percent of revenues: 2.2 percent
16. Debt to EBITDA ratio: 4.4x
17. Debt to capitalization: 35.2 percent
18. Average age of plant: 11.4 years
19. Capital expenditures as percent of depreciation expense: 110.1 percent
Margins, revenue financial benchmarks broken down by rating category:
Source: S&P Global Ratings “U.S. Not-For-Profit Health Care System Median Financial Ratios — 2019 vs. 2021″ report.” The report was released Aug. 30.
“AA+” rating
20. Net patient service revenue: $4.16 billion
21. Total operating revenue: $4.43 billion
22. Operating margin: 4.5 percent
23. Operating EBIDA margin: 11.3 percent
24. Excess margin: 5.5 percent
25. EBIDA margin: 12.2 percent
“AA” rating
26. Net patient service revenue: $3.98 billion
27. Total operating revenue: $4.95 billion
28. Operating margin: 3.2 percent
29. Operating EBIDA margin: 8.3 percent
30. Excess margin: 5.8 percent
31. EBIDA margin: 10.7 percent
“AA-” rating
32. Net patient service revenue: $3.08 billion
33. Total operating revenue: $3.41 billion
34. Operating margin: 1.9 percent
35. Operating EBIDA margin: 7.1 percent
36. Excess margin: 4.1 percent
37. EBIDA margin: 9.2 percent
“A+” rating
38. Net patient service revenue: $2.26 billion
39. Total operating revenue: $2.55 billion
40. Operating margin: 3 percent
41. Operating EBIDA margin: 7.1 percent
42. Excess margin: 5.5 percent
43. EBIDA margin: 10.9 percent
“A” rating
44. Net patient service revenue: $2.69 billion
45. Total operating revenue: $3.07 billion
46. Operating margin: 0.7 percent
47. Operating EBIDA margin: 6.6 percent
48. Excess margin: 5.5 percent
49. EBIDA margin: 2.3 percent
“A-” rating
50. Net patient service revenue: $2.08 billion
51. Total operating revenue: $2.69 billion
52. Operating margin: 0.6 percent
53. Operating EBIDA margin: 6.7 percent
54. Excess margin: 2.4 percent
55. EBIDA margin: 8 percent
“BBB+” rating
56. Net patient service revenue: $1.85 billion
57. Total operating revenue: $2.27 billion
58. Operating margin: -0.2 percent
59. Operating EBIDA margin: 5 percent
60. Excess margin: 0.5 percent
61. EBIDA margin: 6 percent
“BBB” rating
62. Net patient service revenue: $2.96 billion
63. Total operating revenue: $4.11 billion
64. Operating margin: -3.2 percent
65. Operating EBIDA margin: 1.6 percent
66. Excess margin: -2 percent
67. EBIDA margin: 2.8 percent
