Here are 35 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.

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.

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.

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.

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.

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.

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 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.

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.

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.

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.

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.

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.

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.

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 a “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.

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.

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.

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.

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.

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.

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.

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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