Here are 87 health systems with strong operational metrics and solid financial positions, according to reports from credit rating agencies Fitch Ratings and Moody’s Investors Service released in 2026.
Note: This is not an exhaustive list. Health systems were compiled from credit rating reports.
AdventHealth has an “Aa2” rating and stable outlook with Moody’s. The rating is supported by the Altamonte Springs, Fla.-based system’s large scale, concentration in favorable markets and highly centralized operating model, Moody’s said.
Akron (Ohio) Children’s has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the system’s leading pediatric market position across Northeast Ohio, strong brand recognition and broad geographic footprint, Moody’s said. Akron Children’s also has consistently strong financial performance.
Ann & Robert H. Lurie Children’s Hospital of Chicago has an “AA” rating and stable outlook with Fitch. Lurie Children’s is supported by a very strong balance sheet with low leverage ratios from modest debt and strengthening operations, Fitch said.
Ascension has an “Aa3” rating and stable outlook with Moody’s. The agency said the 91-hospital system based in St. Louis has leading market positions, favorable demographics in most of its markets and the ability to use scale to drive efficiencies. Moody’s expects the Amsurg acquisition, which brought Ascension to 312 ambulatory surgery centers, to accelerate growth in profitable non-acute service lines and add to margins.
AtlantiCare Health System has an “AA-” rating and stable outlook with Fitch. The Atlantic City, N.J. system has a strong balance sheet with a low debt burden and a leading market share, Fitch said. The agency expects AtlantiCare’s operating performance will continue to rebound as it leverages technology, streamlines work processes and continues to expand outpatient and key service lines.
Banner Health has an “AA-” rating and stable outlook with Fitch. The Phoenix-based system’s core operations have performed well, providing cushion as it absorbs pressure within its insurance division, Fitch said. Banner has a leading market position and expanding geographic footprint.
Baptist Health has an “AA” rating and stable outlook with Fitch. The rating reflects the Jacksonville, Fla.-based system’s strong and consistent operating performance and a leading market position in a growing service area, Fitch said.
BayCare Health System has an “AA” rating and stable outlook with Fitch. The Clearwater, Fla.-based system’s rating reflects strong operating performance following the dissolution of its joint operating agreement with Livonia, Mich.-based Trinity Health, Fitch said. BayCare’s favorable market positions, disciplined growth, effective cost management and solid strategic execution are expected to drive long-term operational success.
Bayhealth has an “AA” rating and stable outlook with Fitch. The Dover, Del.-based system has a dominant market position, solid operations and a stable financial profile, Fitch said.
Beacon Health System has an “AA-” rating and stable outlook with Fitch. The rating reflects the strength of the South Bend, Ind.-based system’s balance sheet, Fitch said. The agency expects Beacon to successfully implement operating improvement initiatives after acquiring Ascension Michigan’s four-hospital southwest region in July 2025.
Billings (Mont.) Clinic-Logan Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the system’s broad reach as Montana’s largest health system, covering much of the state as well as northern Wyoming, Fitch said. The system captures a nearly 30% statewide market share.
BJC Health has an “Aa2” rating and stable outlook with Moody’s. The St. Louis-based system’s scale and geographic diversification have been enhanced by its ongoing integration of Kansas City, Mo.-based Saint Luke’s Health System, Moody’s said. The completion of a new patient tower further strengthens BJC’s clinical platform, expands capacity and supports long-term strategic positioning.
Bon Secours Mercy Health has an “AA-” rating and stable outlook with Fitch. The Cincinnati-based system has a stable payer mix and holds the leading or secondary market share position in nine of its 11 markets, Fitch said.
Bryan Medical Center has an “AA-” rating and stable outlook with Fitch. The Lincoln, Neb.-based system, has a leading market position as its region’s largest referral center and is well-positioned to accommodate additional growth-oriented strategic investments and capital reinvestment, Fitch said.
Cape Cod Health has an “AA-” rating and stable outlook with Fitch. The Hyannis, Mass.-based system has a strong financial profile, low leverage and a dominant market position, Fitch said. Sizable investments in specialty service lines such as cancer and cardiovascular care also support the system’s rating.
Carle Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the Urbana, Ill.-based system’s leading market position over a broad service area and the expectation the system will sustain strong capital-related ratios, Fitch said.
CaroMont Health has an “AA-” rating and stable outlook with Fitch. The rating reflects Fitch’s expectations that the Gastonia, N.C.-based system’s leading share of a limited-competition primary service area — along with disciplined expense management — will continue to support strong operating margins.
Cedars-Sinai has an “Aa3” rating and positive outlook with Moody’s. The Los Angeles-based system has a leading market position and strong demand for its clinical and research programs, Moody’s said. Steady financial performance and robust philanthropy give Cedars-Sinai room to fund major capital projects, including the soon-to-open Cedars-Sinai Marina Hospital and a new research tower.
CentraCare has an “AA-” rating and stable outlook with Fitch. The St. Cloud, Minn.-based system is expected to sustain strong capital-related ratios despite escalating labor costs and inflationary pressures, Fitch said.
Children’s Health has an “AA-” rating and stable outlook with Fitch. The Dallas-based system’s rating reflects its leading pediatric position, its role as the primary teaching affiliate of University of Texas Southwestern Medical Center and its strong financial profile, Fitch said.
Children’s Mercy has an “Aa2” rating and stable outlook with Moody’s. The rating reflects the Kansas City, Mo.-based system’s strong regional importance, high-acuity services and dominant market position.
Children’s Minnesota has an “AA” rating and stable outlook with Fitch. The Minneapolis-based system has a strong balance sheet, robust liquidity and leading pediatric market position, Fitch said. Fitch also expects the system will see gradual operating improvement as leadership advances efficiency initiatives, service line growth and a major EHR conversion.
Children’s of Alabama has an “AA-” rating and stable outlook with Fitch. The Birmingham-based system’s rating reflects its affiliation with the University of Alabama at Birmingham Heersink School of Medicine, along with strong liquidity, low leverage, philanthropic support, and solid historical and projected operating results, Fitch said.
ChristianaCare has an “Aa2” rating and stable outlook with Moody’s. The rating is supported by the Newark, Del.-based system’s role as Delaware’s largest teaching hospital, extensive clinical depth that affords strong regional and statewide market capture and growing demand, Moody’s said.
Cincinnati Children’s has an “Aa2” rating and stable outlook with Moody’s. The system has a national and international reputation as one of the top children’s hospitals in the U.S. for clinical care and research, which will continue to reinforce its dominant position across a broad service area, Moody’s said.
Cleveland Clinic has an “Aa2” rating and stable outlook with Moody’s. The rating reflects the system’s international brand in advanced clinical care and research, as well as centralized governance, which supports strong patient demand and durable operating improvement, Moody’s said.
Cook Children’s Health Care System has an “Aa2” rating and positive outlook with Moody’s. The Fort Worth, Texas-based system is a leading pediatric provider anchored by dominant regional demand and a broad, high-acuity clinical platform, Moody’s said.
Dayton (Ohio) Children’s has an “AA-” rating and stable outlook with Fitch. The system has robust liquidity, revenue growth and an improved operating performance through the third quarter of fiscal 2026, which ended March 30, Fitch said.
El Camino Health has an “Aa3” rating and stable outlook with Moody’s. The Mountain View, Calif.-based system has consistently strong operating performance, robust liquidity, favorable payer mix and stable market position, Moody’s said.
FirstHealth of the Carolinas has an “AA-” rating and stable outlook with Fitch. The Pinehurst, N.C.-based system has a strong market presence and minimal competition and is supported by steady operating metrics and strategic investments in demographically favorable markets.
Franciscan Alliance has an “AA” rating and stable outlook with Fitch. The Mishawaka, Ind.-based system’s strong balance sheet, competitive market share and operating results in line with historical performance support the rating.
Froedtert ThedaCare Health has an “AA” rating and stable outlook with Fitch. The rating reflects the Menomonee Falls, Wis.-based system’s leading market position as the only academic medical center in Eastern Wisconsin, as well as its solid operating profile and strong balance sheet, Fitch said.
Gundersen Health System has an “AA-” rating and stable outlook with Fitch. The La Crosse, Wis.-based system has strong balance sheet metrics, with high levels of liquidity and a low debt burden, Fitch said.
Hackensack Meridian Health has an “AA-” rating and stable outlook with Fitch. The Edison, N.J.-based system’s strong financial profile is supported by its sizable market presence, steady operating performance and improved unrestricted liquidity position, Fitch said.
Harris Health System has an “AA-” rating and stable outlook with Fitch. The Bellaire, Texas-based system’s rating reflects its strong revenue defensibility, which is backed by its authority to levy property taxes and its role as Harris County’s essential safety-net hospital system, Fitch said.
Hoag Memorial Hospital Presbyterian has an “AA” rating and stable outlook with Fitch. The Newport Beach, Calif.-based system has a leading market position, favorable payer mix and solid operating performance, Fitch said.
Holland (Mich.) Hospital has an “AA-” rating and stable outlook with Fitch. The rating reflects Holland’s stable liquidity and capital metrics despite ongoing sector-wide headwinds, Fitch said.
Houston Methodist has an “AA” rating and stable outlook with Fitch. The system’s favorable service area demographics and a high case index — particularly at its flagship campus in the Texas Medical Center — align with the system’s complex care positioning and strong institutional characteristics, Fitch said.
Inova Health System has an “Aa2” rating and stable outlook with Moody’s. The Falls Church, Va.-based Inova Health’s rating reflects its dominant market position in Northern Virginia, which is supported by a broad network of clinical access points, diverse service offerings, and a wide geographic reach that attracts patients from across the region, Moody’s said.
Intermountain Health has an “Aa1” rating and stable outlook with Moody’s. The Salt Lake City-based system has a distinctly leading market position in Utah across clinical care and insurance operations, and broad service and geographic diversification, Moody’s said. The system also has favorable economic and demographic characteristics in its largest markets.
IU Health has an “AA” rating and stable outlook with Fitch. The rating reflects the Indianapolis-based system’s track record of strong operating margins, Fitch said. The system’s partnership with Indianapolis-based IU School of Medicine — the largest medical school in the country — supports IU Health’s brand and clinical research.
Johns Hopkins Health System has an “AA-” rating and stable outlook with Fitch. The Baltimore-based system has a robust financial profile and a leading market position across central Maryland and the Washington, D.C., region, Fitch said. Its clinical reputation draws patients nationally and internationally.
JPS Health Network has an “AA” rating and stable outlook with Fitch. The rating reflects the Fort Worth, Texas-based system’s significant taxing authority that offsets a constrained payer mix as a safety-net provider, Fitch said.
Kaiser Permanente has an “AA-” rating and stable outlook with Fitch. The rating reflects the Oakland, Calif.-based system’s exceptional financial profile, supported by a large, diversified revenue base, Fitch said. The agency expects Kaiser will maintain profitable operating margins under its highly integrated business model.
Lucile Packard Children’s Hospital has an “AA-” rating and stable outlook with Fitch. The Palo Alto, Calif.-based organization is the Bay Area’s highest-acuity pediatric provider, Fitch said. Lucile Packard has a robust market position and a growing clinical footprint, which have underpinned steady revenue performance.
Mayo Clinic has an “Aa2” rating and stable outlook with Moody’s. The Rochester, Minn.-based system has a favorable payer mix with low Medicaid, which limits exposure to upcoming federal policy changes, and, combined with diversified services and sites, drives more predictable and reliable revenue, Moody’s said.
McLaren HealthCare has an “AA-” rating and stable outlook with Fitch. The Grand Blanc, Mich.-based system benefits from scale and revenue diversity, including health plan and hospital operations, an ambulatory network and Michigan’s largest cancer network, Fitch said.
McLeod Health has an “AA-” rating and positive outlook with Fitch. The Florence, S.C.-based system has seen successful strategic growth, has strong operating results and a leading market position in a stable service area, Fitch said.
Med Center Health has an “AA-” rating and positive outlook with Fitch. The Bowling Green, Ky.-based system has sustained operating profitability and strong cash flow generation, aided by revenue support from Kentucky’s Hospital Rate Improvement Program, Fitch said.
Memorial Sloan Kettering Cancer Center has an “AA” rating and stable outlook with Fitch. New York City-based MSK has a strong reputation as a premier cancer hospital, which Fitch said will continue to support growth and sustain its leading market share.
Methodist Health System has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the Dallas-based system’s strong operating performance and excellent liquidity, which are supported by a favorable demographic backdrop in the Dallas-Fort Worth-Arlington metropolitan area, Moody’s said.
Midland (Texas) Health has an “AA-” rating and stable outlook with Fitch. Midland has a leading market position with limited competition for acute care services, as well as historically strong operating performance, Fitch said.
Monument Health has an “AA-” rating and stable outlook with Fitch. The Rapid City, S.D.-based system has a dominant inpatient market position as the leading acute care provider in its geographically broad service area, Fitch said. The system has made meaningful strides in improving its operating performance over the past two years.
Munson Healthcare has an “AA” rating and stable outlook with Fitch. The Traverse City, Mich.-based system saw its core operations improve in 2024 and 2025, driven by the execution of a financial improvement plan initiated to address expense pressures, Fitch said.
MUSC Health has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the Charleston, S.C.-based system’s role as a public academic medical center, strong student demand, considerable wealth and ongoing support from the state of South Carolina, Moody’s said.
Nationwide Children’s Hospital has an “AA” rating and stable outlook with Fitch. The Columbus, Ohio-based system has a strong, stable market position in an economically diverse primary service area, Fitch said. Its reputation, integrated clinical programs and research draw patients nationally and internationally.
NewYork-Presbyterian has an “AA” rating and stable outlook with Fitch. The New York City-based system is one of the city’s premier academic healthcare systems and its broad clinical footprint allows for resilient demand in a highly competitive market, Fitch said.
Nicklaus Children’s Hospital has an “AA-” rating and stable outlook with Fitch. The rating reflects the Miami-based organization’s position as the premier pediatric hospital in South Florida, with a leading and growing market share and an expanding ambulatory presence outside its main service area, Fitch said.
Novant Health has an “AA-” rating and stable outlook with Fitch. The Winston-Salem, N.C.-based system has a strong market position in attractive service areas, Fitch said. Strong cash flow is expected to support elevated capital spending for continued growth initiatives.
OhioHealth has an “AA+” rating and stable outlook with Fitch. The Columbus, Ohio-based system has an exceptionally strong credit profile, with very robust leverage metrics and consistently strong operating cash flow, Fitch said. A broad regional platform and a leading market position across its competitive 50-county service area support those results.
Parkland Health has an “AA-” rating and stable outlook with Fitch. The Dallas-based system’s rating reflects its position as the primary safety net provider in Dallas County, supported by a significant taxing authority and continued assessed value growth in one of the nation’s largest metro economies, Fitch said.
Phoenix Children’s has an “AA-” rating and stable outlook with Fitch. The organization has a leading pediatric market position in a growing service area, strong operating recovery following the 2024 opening of a new hospital in Glendale, Ariz., and a materially strong balance sheet, Fitch said.
ProHealth Care has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the Waukesha, Wis.-based system’s strong market position, disciplined financial strategy and exceptional liquidity, Moody’s said. The system had 562 days cash on hand as of June 30.
The Queen’s Health Systems has an “AA” rating and stable outlook with Fitch. The Honolulu-based system has a leading statewide market position, broad operating platform and strategic importance as Hawaii’s largest private employer, Fitch said. The system also has diverse revenue streams, including rental income.
Rady Children’s Health has an “AA” rating and stable outlook with Fitch. The rating reflects the San Diego-based system’s robust market position as the high-acuity provider of pediatric services throughout Southern California, its expanded two-campus platform following its merger with Orange, Calif.-based Children’s Hospital of Orange County, and strong financial profile, Fitch said.
Salem (Ore.) Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the system’s dominant market position in a good service area with solid demand for acute care services, Fitch said.
Sarasota (Fla.) Memorial Health Care System has an “AA-” rating and stable outlook with Fitch. The rating reflects the system’s leading market position in a growing area, along with robust operating cash flow and ample liquidity, Fitch said.
Seattle Children’s Hospital has an “AA” rating and stable outlook with Fitch. The rating reflects the system’s market position as the leading provider of high-quality pediatric care across a four-state service area, Fitch said. It also reflects its relationship with the Seattle-based University of Washington School of Medicine and substantial research capabilities.
Sharp HealthCare has an “Aa3” rating and stable outlook with Moody’s. The rating is supported by the San Diego-based system’s strong competitive position, strong clinical offerings, an integrated health plan, extensive physician relationships and a history of well-executed strategic investments, Moody’s said.
Scripps Health has an “AA-” rating and stable outlook with S&P and Fitch. The San Diego-based system’s rating reflects its strong market position, healthy operating performance and substantial unrestricted reserves, S&P said. Scripps reported a 3.25% operating margin in fiscal 2025, while unrestricted reserves grew 12% to $5.27 billion, supporting more than 400 days of cash on hand.
Stanford Health Care has an “AA” rating and stable outlook with Fitch. The Palo Alto, Calif.-based system’s rating is supported by its extensive clinical reach in the greater San Francisco and Central Valley regions, as well as its role as a national/worldwide destination for very high acuity services, Fitch said.
St. Elizabeth Medical Center has an “AA” rating and stable outlook with Fitch. The Edgewood, Ky.-based system holds a commanding 83% share of inpatient volume in its primary service area, Fitch said.
St. Tammany Health System has an “AA-” rating and stable outlook with Fitch. The Covington, La.-based system has a leading market share in a fast-growing service area, favorable payer mix and revenue defensibility under its joint operating agreement with New Orleans-based Ochsner Health, Fitch said.
Sutter Health has an “AA-” rating and stable outlook with Fitch. The Sacramento, Calif.-based system has a broad market presence, strong operating performance and balance sheet strength despite increased capital spending and ongoing expense headwinds, Fitch said.
Texas Children’s has an “AA-” rating and stable outlook with Fitch. The rating reflects the Houston-based organization’s leading pediatric franchise in Houston, as well as its growing presence in Austin and a strong balance sheet that supports sizable capital plans, Fitch said.
Texas Health Resources has an “Aa2” rating and stable outlook with Moody’s. The rating reflects the Arlington-based system’s leading position in the highly competitive Dallas-Fort Worth market, strengthened by its strategic affiliation with Dallas-based UT Southwestern Medical Center (UTSW) and key joint ventures such as Dallas-based Southwestern Health Resources (SWHR), the clinically integrated network the two organizations formed together, Moody’s said.
UAB Health System has an “Aa3” rating and stable outlook with Moody’s. The rating reflects the Birmingham, Ala.-based system’s position as its state’s premier academic medical center, which is also supported by a leading market position, strong statewide referral network and nationally recognized clinical and research programs, Moody’s said.
UCHealth has an “AA+” rating and stable outlook with Fitch. The Aurora, Colo.-based system has a very strong financial profile, benefiting from its market position in a growing service area and a long track record of robust operating margins.
UChicago Medicine has an “AA-” rating and stable outlook with Fitch. The system has a broad and growing reach for high-quality services throughout the Chicago metro area and into northwest Indiana, Fitch said.
UnityPoint Health has an “AA-” rating and stable outlook with Fitch. The rating reflects the West Des Moines, Iowa-based system’s broad patient care platform and service line strategy, as well as Fitch’s expectations for improved operations.
University Health has an “AA+” rating and stable outlook with Fitch. The San Antonio-based system has substantial taxing capacity, strong operating margins and a solid financial position, Fitch said.
University of Kansas Health System has an “AA-” rating and stable outlook with Fitch. The rating reflects the Kansas City-based system’s improving operational results, which are supported by strong demand and expanding scale following the acquisition of Liberty (Mo.) Hospital and Olathe (Kan.) Health.
University of North Carolina Health Care System has an “Aa2” rating and stable outlook with Moody’s. The rating reflects the Chapel Hill, N.C.-based system’s strong overall financial performance, which is underpinned by its reputation as a major academic medical center, ownership ties to the state of North Carolina and key role in statewide healthcare.
University of Pennsylvania Health System has an “Aa3” rating and stable outlook with Moody’s. The rating is supported by the Philadelphia-based system’s strong market profile, led by its academic medical center brand, broad referral base, as well as its ties to the University of Pennsylvania, which will support demand for high-acuity services and continued geographic and ambulatory expansion, Moody’s said.
Valley Health System has an “AA-” rating and stable outlook with Fitch. The Paramus, N.J.-based system has a solid market position within a favorable service area, growing patient volumes and steady operating performance, Fitch said. The system opened a new patient tower in April 2024, and volumes have exceeded projections since. It has also announced plans to build an expansion tower on the new campus to meet patient demand, along with plans to implement a new information technology system.
VHC Health has an “AA-” rating and stable outlook with Fitch. The rating reflects Fitch’s expectation that the Arlington, Va.-based system’s strategic capital investments will drive operating improvement over the medium term as incremental new revenues offset costs associated with the system’s outpatient and inpatient projects.
Willis-Knighton Medical Center has an “AA-” rating and positive outlook with Fitch. The Shreveport, La.-based system has a dominant inpatient market position and strong volume growth, Fitch said. Its operating and financial metrics are on track to support a higher rating near term.
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