Here are 12 health systems with strong operational metrics and solid financial positions, according to reports from Fitch Ratings, Moody's Investors Service and S&P Global Ratings.
Note: This is not an exhaustive list. Health system names were compiled from credit rating reports and are listed in alphabetical order.
1. St. Louis-based BJC HealthCare has an "AA" rating and stable outlook with S&P and an "Aa2" rating and stable outlook with Moody's. The health system has a leading market share and highly regarded reputation, particularly for its flagship hospitals that are affiliated with Washington University School of Medicine in St. Louis, S&P said. The health system has consistently produced stable earnings and cash flow, even during the COVID-19 pandemic, according to the credit rating agency.
2. Evansville, Ind.-based Deaconess Health System has an "AA" rating and stable outlook with Fitch. The health system has strong operating performance and an expanding footprint in a stable and economically diverse service area, Fitch said. Investments in core service lines should help support patient volume growth, according to the credit rating agency.
3. Pinehurst, N.C.-based FirstHealth of the Carolinas has an "AA" rating and stable outlook with Fitch. The health system has a strong financial profile and stable operating performance, despite disruption from the COVID-19 pandemic, Fitch said. The health system's revenue in the first quarter of fiscal 2021 rebounded to levels close to historical trends, according to the credit rating agency.
4. Boston-based Mass General Brigham has an "Aa3" rating and stable outlook with Moody's. The health system has a strong market position, an excellent clinical reputation and strong patient demand, Moody's said. The credit rating agency expects Mass General Brigham to see increasing patient volume and maintain good cash flow as it emerges from the pandemic.
5. Rochester, Minn.-based Mayo Clinic has an "Aa2" rating and stable outlook with Moody's. The health system has strong balance sheet measures, an excellent market position and strong patient demand at its three academic campuses in Minnesota, Arizona and Florida, Moody's said. The credit rating agency expects strong patient demand and steps taken by management to allow Mayo to maintain adequate cash flow and strengthen balance sheet measures.
6. Fountain Valley, Calif.-based MemorialCare has an "AA-" rating and stable outlook with Fitch. The health system has a strong financial profile and maintains high liquidity, Fitch said. The credit rating agency expects the system to generate cash flows of approximately 7 percent in the years after fiscal 2021.
7. Evanston, Ill.-based NorthShore University HealthSystem has an "Aa3" rating and stable outlook with Moody's. The health system has a leading market position, and Moody's expects its operating cash flow margin to improve.
8. St. Louis-based SSM Health has an "AA-" rating and stable outlook with Fitch. The health system's size and scale, including an expanding health plan, support its strong financial profile, Fitch said. The credit rating agency expects the system to sustain strong capital-related metrics.
9. Birmingham, Ala.-based UAB Medicine has an "Aa3" rating and stable outlook with Moody's. The health system has high patient demand, strong margins and a leading market share in Birmingham, Moody's said. The credit rating agency expects UAB Medicine to generate strong cash flow in fiscal year 2021.
10. Aurora, Colo.-based UCHealth has an "Aa3" rating and positive outlook with Moody's. The health system has a reputation for clinical excellence and a growing footprint throughout Colorado, Moody's said. The credit rating agency expects the system's operating performance to remain favorable and its liquidity to remain strong.
11. University of Chicago Medical Center has an "AA-" rating and stable outlook with Fitch. The system has a strong financial profile and operating performance, in part because of its alignment with UChicago, Fitch said. The credit rating agency expects the system's capital-related ratios to remain strong.
12. Philadelphia-based University of Pennsylvania Health System has an "Aa3" rating and stable outlook with Moody's. The health system has a strong reputation and market share in a large service area. The credit rating agency expects the system's margins to approach historical averages in the long term.