Despite economic headwinds, 2025 has brought financial optimism for a growing number of health systems. Fitch Ratings and Moody’s Investors Service have upgraded the outlooks of 18 hospitals and systems, indicating improved operating margins, strategic expansions, and stronger liquidity profiles.
Note: This list is not exhaustive. It was compiled from recent credit rating agency reports.
Highlights from the Field
Here’s a breakdown of systems that earned upgraded outlooks:
| Health System | Rating Agency | Previous Outlook | Current Outlook | Notable Insight |
| Boston Children’s Hospital | Moody’s | Negative | Stable | Margins expected to rise to 4–6% in FY 2025 |
| Broward Health (FL) | Fitch | Stable | Positive | Expansion via outpatient sites |
| Butler Health System (PA) | Moody’s | Negative | Stable | Improved performance and covenant compliance |
| DCH Health Care (AL) | Moody’s | Negative | Stable | Sustainable operating improvements |
| EvergreenHealth (WA) | Moody’s | Negative | Stable | Reduced enterprise risk |
| Hutchinson Regional MC (KS) | Moody’s | Negative | Stable | Break-even to positive cash flow expected |
| Hurley Medical Center (MI) | Moody’s | Stable | Positive | Boost from Medicaid-directed payments |
| Kettering Health (OH) | Moody’s | Stable | Positive | Strong liquidity and cash flow margins |
| Mary Washington Healthcare (VA) | Fitch | Stable | Positive | Capacity for debt and investment growth |
| Miami Jewish Health Systems (FL) | Fitch | Negative | Stable | Met fiscal 2024 covenants |
| Nuvance Health (CT/NY) | Moody’s | Negative | Stable | Merger strengthens financial sustainability |
| Phoenix Children’s Hospital (AZ) | Moody’s | Stable | Positive | Expansion supports cash flow and liquidity |
| Rex Healthcare (NC) | Fitch | Stable | Positive | Steady performance improvements expected |
| San Antonio Regional Hospital (CA) | Moody’s | Stable | Positive | Maintains 8% operating cash flow |
| Tampa General Hospital (FL) | Moody’s | Stable | Positive | Integrated new hospitals successfully |
| Texas Medical Center (TX) | Moody’s | Stable | Positive | Exceptional performance and liquidity |
| UC Health (OH) | Moody’s | Stable | Positive | Growth from strategic improvements |
| Wayne Healthcare (OH) | Fitch | Stable | Positive | Converted to critical access hospital |
Trends Driving Financial Momentum
Across these upgrades, three key themes emerged:
- Operational Efficiency: Many systems are showing tighter budget controls and improved margins.
- Strategic Expansions: Outpatient centers, service lines, and mergers have helped increase reach and market capture.
- Liquidity Strength: Bond proceeds, fundraising, and investment strategies are reinforcing financial stability.
What It Means
In a year marked by cost pressures and policy uncertainty, these upgraded outlooks offer a glimpse of resilience. Hospitals investing in growth and innovation—while maintaining fiscal discipline—are earning greater confidence from investors and rating agencies alike.