Fitch Ratings affirmed its "A+" rating on Raleigh, N.C.-based WakeMed Health System's bonds, affecting about $393.3 million of debt.
Concurrently, Fitch assigned WakeMed an issuer default rating of "A+."
The affirmation and assignment are based on several factors, including WakeMed's strong market position, favorable service area, healthy operating margins and solid liquidity metrics.
The outlook is revised to positive from stable.