Moody's Investors Service revised its rating outlook for Evanston, Il.-based NorthShore University HealthSystem from stable to negative, and affirmed its "Aa2" and "Aa2/VMIG 1" ratings.
The outlook revision reflects Moody's view that NorthShore will face difficulties reversing two years of low margins, though the ratings affirmation acknowledges that the system will maintain its strong market position in a favorable service area.
Moody's said volume declines, more competition and the presence of a dominant commercial payer will continue to compress margins.