Fitch Ratings assigned an "AA" rating to Durham, N.C.-based Duke University Health System's $600 million of series 2017 taxable bonds.
Fitch also affirmed the "AA" rating on $572 million of revenue bonds issued on behalf of Duke Health by the North Carolina Medical Care Commission.
The ratings assignment and affirmation are based on a number of factors, including the health system's clinical reputation, operating profitability and increased debt burden.
The outlook is stable.