Here are 14 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. Advocate Aurora Health has an "AA" rating and stable outlook with Fitch. The health system, dually headquartered in Milwaukee and Downers Grove, Ill., has a strong financial profile and a leading market position over a broad service area in Illinois and Wisconsin, Fitch said. The health system's fundamental operating platform is strong, the credit rating agency said.
2. AnMed Health has an "AA-" rating and stable outlook with Fitch. The Anderson, S.C.-based system has a leading market share in most service lines, strong operating performance and very solid EBITDA margins, Fitch said.
3. 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.
4. Bon Secours Mercy Health has an "AA-" rating and stable outlook with Fitch. The Cincinnati-based health system has a broad geographic footprint as one of the five largest Catholic health systems in the U.S., a good payer mix and a leading or near leading market share in eight of its eleven markets in the U.S., Fitch said.
5. 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.
6. Franciscan Alliance has an "AA" rating and stable outlook with Fitch. The Mishawaka, Ind.-based health system has a very strong cash position and maintains leading market shares in seven of its nine defined primary service areas, Fitch said. The health system benefits from a good payer mix, the credit rating agency said.
7. Gundersen Health System has an "AA-" rating and stable outlook with Fitch. The La Crosse, Wis.-based health system has strong balance sheet metrics and a leading market position and expanding operating platform in its service area, Fitch said. The credit rating agency expects the health system to return to strong operating performance as it emerges from disruption related to the COVID-19 pandemic.
8. Hackensack Meridian Health has an "AA-" rating and stable outlook with Fitch. The Edison, N.J.-based health system has shown consistent year-over-year increases in market share and has a solid liquidity position, Fitch said.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. Yale New Haven (Conn.) Health has an "AA-" rating and stable outlook with Fitch. The health system's turnaround efforts, brand recognition and market presence will help it return to strong operating results, Fitch said.