8 health systems with strong finances

Here are eight health systems with strong operational metrics and solid financial positions, according to recent reports from Moody's Investors Service, Fitch Ratings and S&P Global Ratings.

Note: This is not an exhaustive list. Health system names were compiled from recent credit rating reports and are listed in alphabetical order.

1. Minneapolis-based Allina Health has an "AA-" rating and stable outlook with S&P. Allina has a leading market position in a very competitive service area and a stable financial profile, according to S&P.

2. Hackensack Meridian Health has an "AA-" rating and stable outlook with Fitch. The Edison, N.J.-based health system has a strong market position, favorable payer mix, consistent operating performance and strong cash to adjusted debt ratios, according to Fitch.

3. Inova Health System has an "Aa2" rating and stable outlook with Moody's. The Falls Church, Va.-based health system has consistently strong cash flow margins, a leading market position in a competitive market, a good investment position and a strong management team with a proven track record of meeting or exceeding budgets and responding to competition quickly, according to Moody's.

4. Oakland, Calif.-based Kaiser Permanente has an "AA-" rating and stable outlook with Fitch. The health system has a dominant market share in California and sound profitability, according to Fitch. The credit rating agency expects Kaiser's operating margins to support elevated capital spending.

5. NCH Healthcare System has an "AA-" rating and stable outlook with Fitch. The Naples, Fla.-based system has a strong market position, a favorable payer mix and a growing service area that supports revenue and growth prospects, according to Fitch.

6. Portland-based Oregon Health & Science University has an "Aa3" rating and stable outlook with Moody's. OHSU has very strong philanthropy, offers high-level tertiary and quaternary procedures, and includes a competitive medical school, according to Moody's. The rating agency expects OHSU to maintain a healthy operating margin and improve its balance sheet over time.

7. Scripps Health has an "Aa3" rating and stable outlook with Moody's. The San Diego-based health system has a healthy market position, strong brand recognition and a solid management team, according to Moody's.

8. Sentara Healthcare has an "Aa2" rating and stable outlook with Moody's. The Norfolk, Va.-based health system has a leading market position in its core service area and strong patient demand that will translate to consistently solid margins, according to Moody's.

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