Here are 10 hospitals and 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 and are listed in alphabetical order.
1. Altamonte Springs, Fla.-based AdventHealth has an "Aa2" rating and stable outlook from Moody's. The credit rating agency said the system benefits from strong operating cash flow margins, low operating leverage and a large scale with presence in multiple states.
2. Children's Hospital of Philadelphia has an "Aa2" rating and stable outlook from Moody's. The credit rating agency said the rating is reflective of Children's Hospital of Philadelphia's strong market position and brand equity as a top U.S. children's hospital with advanced clinical research. The pediatric hospital network also has strong liquidity.
3. Cleveland Clinic has an "Aa2" rating and stable outlook from Moody's. The credit rating agency said the health system benefits from its reputation as an international brand, which will allow it to grow revenue outside of the Ohio market. Moody's said it maintains good cash flow margins and therefore very strong liquidity.
4. Cottage Health in Santa Barbara, Calif., has an "AA-" rating and stable outlook from Fitch. The credit rating agency said Cottage benefits from consistently strong profitability, a strong balance sheet and leading market position. Fitch also said the health system has broad reach in a service area that has high demand for acute care services.
5. Froedtert Health in Wauwatosa, Wis., has an "AA" rating and stable outlook from Fitch. The credit rating agency said the rating reflects the health system's solid market position and robust liquidity position, as well as its strong utilization trends and operational metrics in recent years.
6. Indiana University Health in Indianapolis has an "AA" rating and positive outlook from Fitch. The credit rating agency said the health system has a long track record of strong operating margins and a "remarkably solid" balance sheet. The system also benefits as the largest healthcare system and academic medical center in Indiana, according to Fitch.
7. Vineland, N.J.-based Inspira Health has an "AA-" rating and stable outlook from Fitch. The credit rating agency said the rating is supported by Inspira's stable financial profile, leading market position, large medical staff and expansive outpatient network. Fitch also said Inspira saw a strong operating performance through the construction and transition of its new campus, an IT implementation and through the peak of the pandemic.
8. Sanford Health in Sioux Falls, S.D., has an "AA-" rating and stable outlook from Fitch. The credit rating agency said the "AA-" rating reflects Sanford's leading inpatient market share in multiple states and strong financial profile. Fitch also said Sanford's growing health plan and plan for continued improvement and balance sheet growth are credit positives.
9. Spectrum Health in Grand Rapids, Mich., has an "Aa3" rating and stable outlook with Moody's. The credit rating agency said the health system has a stable operating performance and strong balance sheet metrics. In particular, the system generated positive margins even without federal aid in fiscal year 2020. Moody's said the health system will continue to benefit from a strong market share for patient care in western Michigan.
10. Texas Children's Hospital in Houston has an "Aa2'' rating and stable outlook from Moody's. The credit rating agency said the children's hospital network benefits from favorable leverage metrics and strong liquidity. Moody's also said Texas Children's has very strong patient demand and high acuity services as the academic medical center for Baylor College of Medicine's pediatric department in Houston.