The nonprofit healthcare sector could take at least two more years to recover to somewhere near pre-pandemic levels after the "rapid deterioration" in financial performance during much of 2022, S&P Global said in a June 28 midyear update.
The sector view remains negative.
Such a slow recovery will likely see both reduced operating losses and some breakeven to slightly positive margins, S&P said.
There will also be differences depending on geography, the agency said. The Pacific Northwest, upper Midwest and parts of the Northeast have generally shown greater operating losses, while population growth and payer/reimbursement dynamics in other parts of the country have resulted in better outcomes.
The continuing challenging environment will also likely lead to sustained merger and acquisition activity in the sector though the longer-term effects of such a dynamic will not be known for a while.
"Whether these mergers help maintain long-term credit stability and are successful in achieving providers' goals will likely play out over several years," S&P said.
Absolute rating actions could begin to slow in the next few months. S&P Global did not downgrade any healthcare systems in May.