Moody's Investors Service has affirmed the "Aa2" rating assigned to Durham, N.C.-based Duke University Health System, affecting $1.02 billion of revenue bonds issued through the North Carolina Medical Care Commission.
The rating affirmation is based on a number of factors, including DUHS' size, scope of operations as a leading academic medical center and its relationship with Durham, N.C.-based and "Aa1"-rated Duke University.
The outlook remains stable, reflecting Moody's expectation that although DUHS may not generate as strong of operating margins as in fiscal year 2015, it will continue to have sound operating cash flow margins — likely in the 10 to 11 percent range — over time.