S&P Global Ratings affirmed the "AA" rating on Philadelphia-based Main Line Health System's fixed-rate revenue bonds, affecting $188 million of rated debt.
S&P also assigned an "AA" rating to $105.5 million series 2017A fixed-rate bonds issued by the Chester County Health and Educational Facilities Authority for Main Line Health System.
S&P said the affirmation of Main Line Health System's credit rating is attributed to the system's light outstanding debt levels, strong balance sheet, healthy philanthropy and strong market position.
The outlook was revised to stable from positive, which reflects the system's lower than expected earnings and cash flow in fiscal 2017 year to date.