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. Hospital and health system names were compiled from credit rating reports and are listed in alphabetical order.

1. Aspen (Colo.) Valley Health District has an "Aa2" rating and stable outlook with Moody's. The district, which includes a 25-bed hospital, has a large and affluent tax base in Pitkin County (Colo.), and it has a historically positive operating performance, Moody's said. 

2. South Bend, Ind.-based Beacon Health System has an "AA-" rating and stable outlook with Fitch. Beacon is the acute care leader in its northern Indiana service area and has a track record of strong operating margins, Fitch said. The credit rating agency expects Beacon to return to strong operating margins and sustain strong liquidity, despite pressure from the COVID-19 pandemic.  

3. Carle Foundation, a three-hospital system based in Urbana, Ill., has an "AA-" rating and stable outlook with Fitch. The health system has a very strong financial profile, and Fitch expects it to sustain profitable operating margins after managing through the pandemic. 

4. Saint Joseph, Mo.-based Mosaic Health System has an "AA-" rating and stable outlook with Fitch. The health system is a market leader in a multicounty service area and has a track record of strong operating results, Fitch said. The credit rating agency expects Mosaic will sustain strong operating margins and maintain healthy liquidity and leverage metrics, despite the pressure of the COVID-19 pandemic. 

5. Tacoma, Wash.-based MultiCare Health System has an "Aa3" rating and stable outlook with Moody's and an "AA-" rating and stable outlook with Fitch. The 10-hospital system has an extensive footprint, a track record of successfully executing  multiple projects and strategic ventures concurrently and good financial management, Moody's said. The credit rating agency expects MultiCare to return to stronger operating results after recovering from disruptions related to the COVID-19 pandemic.

6. San Diego-based Rady Children's Hospital and Health Centers has an "Aa3" rating and stable outlook with Moody's. The hospital has a reputation for clinical excellence, and its unrestricted cash reserves have grown significantly over the years, Moody's said. 

7. Arlington-based Texas Health Resources has an "Aa2" rating and stable outlook with Moody's. The health system has a strong cash position and cash measures, Moody's said. The credit rating agency said the health system will likely recover from revenue declines in fiscal 2020 linked to the pandemic. 

8. Iowa City-based University of Iowa Hospitals and Clinics has an "Aa2" rating and stable outlook with Moody's. It is the only academic medical center in Iowa and has conservative balance sheet management and strong patient demand, Moody's said. The credit rating agency expects the health system to rebound to more normalized operating levels after challenges of the COVID-19 pandemic. 

9. Yale New Haven (Conn.) Health has an "AA-" rating and stable outlook with S&P, an "AA-" rating and stable outlook with Fitch and an "Aa3" rating and stable outlook with Moody's. The health system has a leading market position in Connecticut, strong brand recognition and historically strong operating cash flow margins, Moody's said. 

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