Here are 10 health systems with strong operational metrics and solid financial positions, according to reports from Fitch Ratings and Moody's Investors Service.
Note: This is not an exhaustive list. Health system names were compiled from credit rating reports.
1. Banner Health has an "AA-" rating and stable outlook with Fitch. The Phoenix-based health system's core hospital delivery system and growth of its insurance division combine to make it a successful highly integrated delivery system, Fitch said. The credit rating agency said it expects Banner to maintain operating EBITDA margins of about 8 percent on an annual basis, reflecting the growing revenues from the system's insurance division and large employed physician base.
2. Lincoln, Neb.-based Bryan Health has an "AA-" rating and stable outlook with Fitch. The health system has a leading and growing market position, very strong cash flow and a strong financial position, Fitch said. The credit rating agency said Bryan Health has been resilient through the COVID-19 pandemic and is well-positioned to accommodate additional strategic investments.
3. Evansville, Ind.-based Deaconess Health System has an "AA" rating and stable outlook with Fitch. The health system has a stable balance sheet and its operating metrics are consistent with continued enterprise growth, Fitch said. The credit rating agency said it expects Deaconess Health's EBITDA margins to improve and stabilize around 10 percent by next year.
4. Falls Church, Va.-based Inova Health System has an "Aa2" rating and stable outlook with Moody's. The health system has a consistently strong operating cash flow margin and ample balance sheet resources, Moody's said. Inova's financial excellence will remain undergirded by its favorable regulatory and economic environment, the credit rating agency said.
5. Salt Lake City-based Intermountain Healthcare has an "Aa1" rating and stable outlook with Moody's. The health system has exceptional credit quality, which will continue to benefit from its leading market position in Utah, Moody's said. The credit rating agency said the health system's merger with Broomfield, Colo.-based SCL Health will give Intermountain greater geographic reach.
6. Omaha-based Nebraska Medicine has an "AA-" rating and stable outlook with Fitch. The health system has a strong market position and is the only public academic provider in Nebraska with high acuity services, Fitch said. The health system continues to generate positive operating cash flow levels, and it has modest flexibility to absorb additional debt, according to the credit rating agency.
7. New York-Presbyterian has an "Aa2" rating and stable outlook with Moody's. The New York City-based system has strong liquidity, and its margins will be supported by good patient volume recovery, Moody's said. The health system's brand, academic affiliations and centralized management will underpin strategies to reduce costs and grow revenue, according to the credit rating agency.
8. Fort Wayne, Ind.-based Parkview Health has an "Aa3" rating and stable outlook with Moody's. The health system has a leading market position with expansive tertiary and quaternary clinical services in northeastern Indiana and northwestern Ohio, Moody's said. The credit rating agency said the stable outlook reflects management's ability to generate strong operating performance during the pandement and with less favorable reimbursement rates.
9. Sharp HealthCare has an "Aa3" rating and stable outlook with Moody's. The San Diego-based health system has a strong balance sheet, good debt measures, diversified revenue streams and a history of stable operating performance, Moody's said. Sharp HealthCare's other strengths include consistent market share gains and strong clinical offerings, according to the credit rating agency.
10. UnityPoint Health has an "AA-" rating and stable outlook with Fitch. The Des Moines, Iowa-based health system has strong leverage metrics and cash position, Fitch said. The credit rating agency expects the health system's balance sheet and debt service coverage metrics to remain robust.