Albuquerque, N.M.-based Presbyterian Healthcare Services’ credit rating was downgraded to “AA-” from “AA” by Fitch.
The downgrade reflects several years of weak operating performance at the integrated health system that “consistently fell short of management’s expectations,” Fitch said in a Feb. 24 report. The health system’s losses grew in fiscal 2025, even after incorporating additional funds from New Mexico’s State Directed Payment Program.
Fitch said the health system expects to see a significant increase in top-line revenue from higher Medicaid rates that should help support improvement. The system’s outlook remains negative, however, because it continues to face headwinds such as a pressured labor market and rising medical costs. State reimbursement rates have not kept pace with higher member acuity and utilization.
Presbyterian Healthcare Services’ financial profile remains healthy despite persistently weak cash flow, Fitch said. The system is also the market share leader for acute care services in the Albuquerque metro area, capturing 48.4% of inpatient admissions in 2025. Its health insurance business, Presbyterian Health Plan, has one of the largest membership bases in New Mexico and the largest Medicaid managed care plan in the state.
Despite challenges in recent years, Fitch said it believes the health plan provides long-term operational stability to the health system.
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