8 health systems with boosted outlooks

Here are eight health systems that recently had their outlooks upgraded by Fitch Ratings or Moody’s Investors Service in 2026.

Note: This is not an exhaustive list. Health systems were compiled from credit rating reports.

Cook Children’s Medical Center’s outlook was revised to positive from stable by Moody’s. The revision reflects the Fort Worth, Texas-based system’s strong financial performance and excellent management as it executes a multi-year, $1.25 billion capital project, Moody’s said. Cook Children’s has an “Aa2” rating with the agency.

Crouse Health’s outlook was revised to stable from negative by Fitch. The revision reflects the Syracuse, N.Y.-based system’s improved liquidity at the end of fiscal 2025, Fitch said. It also reflects Fitch’s anticipation of further balance sheet improvements from the March sale of laboratory assets to Labcorp and a $113 million Safety Net Transformation Program award from the state of New York. Crouse has a “B” rating with Fitch.

Dolly Parton Children’s Hospital’s outlook was revised to positive from stable by Fitch. The revision reflects the Knoxville, Tenn.-based hospital’s liquidity growth and strong cash flow generation, aided by support from Tennessee’s Hospital Investment Program, Fitch said. The hospital, formerly known as East Tennessee Children’s Hospital, has an “A” rating with the agency.

Med Center Health’s  outlook was revised to positive from stable by Fitch. The revision reflects the Bowling Green, Ky.-based system’s sustained operating profitability and strong cash flow generation, aided by revenue support from Kentucky’s Hospital Rate Improvement Program, Fitch said. Med Center Health has an “AA-” rating with the agency.

RWJBarnabas Health’s outlook was revised to positive from stable by Moody’s. The revision reflects the West Orange, N.J.-based system’s strengthened financial and operating performance and rising cash reserves, Moody’s said. These improvements come amid substantial capital investments, demonstrating the system’s highly effective financial strategy and risk management.

South Shore Health’s outlook was revised to stable from negative by Moody’s. The revision reflects quarterly improvement in financial performance at the South Weymouth, Mass.-based system and Moody’s expectations that strong margins demonstrated in the first quarter of fiscal 2026 will be sustained. The system has a “Baa2” rating with Moody’s.

UPMC’s outlook was revised to stable from negative by Fitch. The revision reflects UPMC’s material operating performance improvement in 2025, Fitch said in a March 5 report. UPMC recorded an operating income of $286 million (0.9% operating margin) in 2025, an improvement from an operating loss of $339 million (-1.1% margin) in 2024. UPMC has an “A” rating with the agency.

Vandalia Health’s outlook was revised to stable from negative by Moody’s. The revision reflects the Charleston, W.Va.-based system’s improved cash flow, supported by new directed payment program funds, and expectations that balance sheet measures will build from currently modest levels. Vandalia has a “Baa1” rating with the agency.

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