Fitch predicts HCA's operating cash flow will top $6B in 2019

Fitch Ratings assigned a "BB+" rating to Nashville, Tenn.-based HCA Healthcare's $35 billion of debt.

Fitch said the credit rating assignment is supported by several factors, including HCA's financial flexibility and stable leverage.

"HCA's operating profile is the strongest in the investor owned acute care hospital category, benefiting from good geographic diversification and depth of operating assets within the company's markets," Fitch said in a press release announcing the rating assignment.

The credit rating agency forecasts HCA will produce cash flow from operations of $6.4 billion in 2019.

Although HCA has a strong operating profile, the company isn't immune to weak organic operating trends in the for-profit hospital industry, according to Fitch.

"The hospital industry is facing secular headwinds to organic growth, but HCA's hospitals are primarily located in urban or large suburban markets that have relatively favorable prospects," the credit rating agency said.

Fitch said HCA's credit rating outlook is stable.

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