Moody's Investors Service affirmed its "A2" rating on Topeka, Kan.-based Stormont-Vail Healthcare's bonds, affecting $189 million of outstanding debt.
The affirmation is a result of several factors, including the health system's dominant market position, demographically stable service area, investment in its employed physician group and strong balance sheet metrics.
The outlook was revised to negative from stable, reflecting the health system's upcoming challenges that may weigh on operating performance in fiscal year 2018, including higher physician retention costs, an increase in drug expenses due to 340B rebates withheld by Kansas and a new competitor in the area.