S&P Global Ratings affirmed its "A+" rating on Midland-based MidMichigan Health's revenue debt.
In addition, S&P revised MidMichigan Health's outlook to positive.
"The positive outlook reflects our view of MidMichigan's steady operational performance in recent years, with good maximum annual debt service coverage and a solid balance sheet, particularly with respect to system medians for the rating level," said Avani Parikh, an S&P Global Ratings credit analyst.