The long-term rating affirmation is a result of Cleveland Clinic’s strong brand recognition, integrated governance structure, exceptional fundraising ability and healthy cash flow. Moody’s acknowledged the health system’s moderately high leverage as it uses debt to fund growth strategies as well as its elevated execution risks related to expanding into London and Florida.
The outlook is stable, reflecting Moody’s expectation that margins and liquidity will be sustained long-term, despite the system’s plan to expand into new markets.
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