9 health systems with strong finances

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

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

1. Advocate Aurora Health, which has dual headquarters in Milwaukee and Downers Grove, Ill., has an "Aa3" rating and positive outlook with Moody's and an "AA" rating and stable outlook with S&P. Moody's said it expects Advocate Aurora to maintain low leverage, a favorable liquidity position and healthy long-term margins, despite the near-term impact from COVID-19. 

2. Phoenix-based Banner Health has an "AA-" rating and stable outlook with Fitch and an "AA-" rating and stable outlook with S&P. The health system has a strong financial profile and growing financial stability in its insurance division, Fitch said. Notwithstanding the impact from the COVID-19 pandemic, Fitch expects Banner's improvement to operating margins will resume and continue to support spending levels and liquidity growth. 

3. Clearwater, Fla.-based BayCare Health System has an "Aa2" rating and stable outlook with Moody's. The health system has strong operating performance and favorable balance sheet metrics, Moody's said. The credit rating agency expects the health system to maintain strong liquidity and to move quickly with capital expansion. 

4. Cincinnati-based Bon Secours Mercy Health has an "AA-" rating and stable outlook with Fitch. The health system has a broad geographic footprint, a good payer mix and a strong financial profile, Fitch said. The credit rating agency anticipates that Bon Secours Mercy Health will increase capital spending over the next three years due to strategic investments in its expanded markets.

5. Omaha, Neb.-based Children's Hospital and Medical Center has an "AA-" rating and stable outlook with Fitch. The hospital has a dominant market position as the only comprehensive pediatric provider in Nebraska, and its operating cash flow levels are robust enough to absorb any short-term pressure related to the COVID-19 pandemic, Fitch said. 

6. Naples, Fla.-based NCH Healthcare System has an "AA-" rating and stable outlook with Fitch. The health system has a strong financial profile, robust operating performance and a leading market position in a favorable service area, Fitch said. 

7. Stanford (Calif.) Health Care has an "Aa3" rating and stable outlook with Moody's. The health system has unique clinical offerings and a strong reputation for patient care and research, Moody's said. The credit rating agency expects Stanford Health Care to maintain strong patient demand and grow absolute cash flow over the next several years.

8. West Des Moines, Iowa-based UnityPoint Health has an "AA-" rating and stable outlook with Fitch. The health system has strong leverage metrics and regional diversification, Fitch said. The credit rating agency expects the system's cash flow margins to return to levels of at least 7 percent beyond early 2021 after declining in 2020 due to the COVID-19 pandemic. 

9. Arlington-based Virginia Hospital Center has an "AA-" rating and stable outlook with Fitch. The credit rating agency expects Virginia Hospital Center's strong operating performance to continue after the market recovers from the COVID-19 pandemic. 

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