Here are 22 health systems that have had their credit ratings upgraded by Fitch Ratings or Moody's Investor Services in 2024:
1. OU Health was upgraded to "Ba2" from "Ba3" by Moody's. The Oklahoma City-based system's upgrade is attributed to a significant financial improvement stemming from material supplemental Medicaid funding, which Moody's said will drive a sustained reduction in operating leverage.
2. St. Francis Regional Medical Center was upgraded to "A+" from "A" by Fitch. The upgrade reflects the Shakopee, Minn.-based system's very strong financial and operating risk profiles, Fitch said.
3. Catholic Health System was upgraded to "B3" from "Caa1" by Moody's. The Buffalo, N.Y.-based system's upgrade reflects recent projected liquidity growth from anticipated receipt sizable, recently approved FEMA grants and a substantial and recurring improvement in operating performance, Moody's said. The system has a positive outlook at its new rating.
4. St. Joseph's/Candler Health System was upgraded to "A+" from "A" by Fitch. The upgrade reflects the Savannah, Ga.-based system's operational resiliency over the past five years despite significant sector headwinds, Fitch said.
5. Doylestown (Pa.) Health was upgraded to "B2" from "B3" by Moody's. The upgrade was driven by a significant reduction of a number of key credit risks, as well as "significant and seemingly sustainable improvement" in financial performance and stronger liquidity, Moody's said.
6. Mercy Health Services was upgraded to "A3" from "Baa1" by Moody's. The upgrade reflects the Baltimore-based system's "increased unrestricted liquidity and lower leverage achieved over multiple years owing to strong and stable operating performance, a governance consideration," Moody's said.
7. Memorial Hospital at Gulfport (Miss.) was upgraded to "BBB" from "BBB-" by Fitch. The upgrade reflects materially improved operating performance following Memorial Hospital's turnaround initiatives that began in 2022, Fitch said.
8. Nebraska Methodist Health System was upgraded to "A+" from "A" by Fitch. The upgrade reflects the Omaha-based system's exceptional liquidity position, growing market share in its highly competitive primary market service area and expectation of improved operational performance, returning to solid operating cash flow levels, Fitch said.
9. Erlanger Health System was upgraded to "Baa1" from "Baa2" by Moody's. The upgrade reflects the Knoxville, Tenn.-based system's successful execution of key initiatives to drive stronger operating results and grow liquidity, Moody's said. Erlanger's outlook remains positive at the higher rating level.
10. Bronson Healthcare was upgraded to "A1" from "A2" by Moody's. The upgrade reflects the Kalamazoo, Mich.-based system's stronger operating performance which will be sustained with high single digit operating cash flow margins going forward, Moody's said.
11. Confluence Health was upgraded to "A" from "A-" by Fitch. The upgrade reflects the Wenatchee, Wash.-based system's stronger and improved balance sheet metrics, consistently positive and improving operating performance, combined with its dominant market position, Fitch said.
12. San Antonio Regional Hospital was upgraded to "Baa1" from "Baa2" by Moody's. The upgrade reflects the Upland, Calif.-based system's multi-year trend of stronger financial results and materially improved liquidity metrics including over 200 days cash on hand, Moody's said.
13. Nicklaus Children's Hospital was upgraded to "AA-" from "A+" by Fitch. The upgrade is based on the Miami-based system's strong operating results over the past four years.
14. Stormont-Vail HealthCare was upgraded to "A1" from "A2" by Moody's. The upgrade reflects the Topeka, Kan.-based system's strong liquidity and excellent debt measures, supported by stable operating performance, Moody's said.
15. Prime Healthcare was upgraded to "BBB+" from "BBB" by Fitch. The Ontario, Calif.-based health system's upgrade is based on material improvement in 2023 operating results as well as solid liquidity and moderate leverage, Fitch said.
17. Akron (Ohio) Children's Hospital was upgraded to "Aa3" from "A1" by Moody's. The rating agency said the upgrade reflects expected maintenance of strong operating performance and liquidity, driven by new growth initiatives.
17. CommonSpirit Health was upgraded to "A3" from "Baa1" by Moody's. The Chicago-based system has achieved many of the operational and organizational integration goals it established upon formation, Moody's said.
18. El Camino Health was upgraded to "AA" from "AA-" by Fitch. The upgrade reflects the Mountain View, Calif.-based system's strong operating profile assessment with a history of generating double-digit operating EBITDA margins anchored by a service area that features strong demographics as well as a healthy payer mix.
19. Irving (Texas) Hospital Authority was upgraded to "Baa1" from "Baa2" by Moody's. The upgrade reflects solid and growing contingent rent payments from tenant Baylor Scott & White Medical Center-Irving due to substantial increases in volumes and insured patients following the renovation of the main campus, Moody's said.
20. Martin County Hospital District, which owns and operates an 18-bed critical access hospital in Stanton, Texas, had its rating upgraded to "A-" from "BBB+" by Fitch. The upgrade reflects its status as the sole community provider in the county and strong cash flow generation that led to significant growth in unrestricted liquidity over the past few years, Fitch said.
21. NYU Langone Health was upgraded to "A1" from "A2" by Moody's. The New York City-based system's upgrade reflects expected continuation of strong and consistent operating performance and revenue growth relative to peers, driven by its strong market position and highly effective and disciplined leadership, the ratings agency said.
22. Saint Luke's Health System was upgraded to "Aa2" from "A1" by Moody's. The Kansas City, Mo.-based system's rating was upgraded after its merger with St. Louis-based BJC HealthCare was completed in January.