20 health systems with upgraded outlooks in 2026

Fitch Ratings and Moody’s Investors Service recently upgraded the outlooks of 20 health systems in 2026. The list is not exhaustive, and the systems were compiled from credit rating reports. The revisions generally reflected improving operating results, better liquidity, stronger cash flow and, in some cases, support from supplemental funding, program payments or capital investment initiatives.

Adena Health System’s outlook was revised to stable from negative by Moody’s. The Chillicothe, Ohio-based system was cited for continued performance improvement, supported by stronger operations and increased supplemental funding that Moody’s said will help Adena through a period of higher leverage. The agency said the system carries an A3 rating.

Arkansas Children’s also received a more favorable outlook from Moody’s, which changed the Little Rock-based organization’s outlook to positive from stable. Moody’s said the revision reflects growing patient demand, philanthropy and state support. Those factors, the agency said, should help sustain strong financial performance and liquidity. Arkansas Children’s has an A1 rating with Moody’s.

Baptist Health Care’s outlook was revised to positive from stable by Fitch. The Pensacola, Fla.-based system was recognized for leading market share in key service lines, along with the long-term benefits of a replacement hospital that opened in September 2023. Fitch said the system has a BBB rating.

Baptist Memorial Health Care also saw its outlook move to positive from stable, with Fitch pointing to sustained operating performance improvement. The Memphis, Tenn.-based system’s acquisition and integration success in recent years was described as a key strength. Fitch said the system has a BBB+ rating.

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

Crouse Health’s outlook was revised to stable from negative by Fitch. The Syracuse, N.Y.-based system was cited for improved liquidity at the end of fiscal 2025. Fitch also said it expects additional balance sheet improvement 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, formerly known as East Tennessee Children’s Hospital, had its outlook revised to positive from stable by Fitch. The Knoxville, Tenn.-based hospital was credited with liquidity growth and strong cash flow generation, aided by support from Tennessee’s Hospital Investment Program. Fitch said the hospital has an A rating.

Fred Hutchinson Cancer Center’s outlook was revised to stable from negative by Moody’s. The Seattle-based organization was cited for significantly improved operating performance through the first six months of fiscal 2026. Moody’s said it expects results going forward to remain around current levels. Fred Hutchinson has an A2 rating.

Halifax Health’s outlook was revised to positive from stable by Fitch. The Daytona Beach, Fla.-based system was recognized for continued strong financial results that Fitch expects will produce cash flows sufficient to support capital spending plans while also growing the balance sheet. Halifax has an A- rating with Fitch.

Lucile Salter Packard Children’s Hospital’s outlook was revised to positive from stable by Moody’s. The Palo Alto, Calif.-based organization was cited for significant financial performance improvement, continued strengthening of debt measures and ongoing growth in its footprint, clinical offerings and revenue base. Moody’s said LPCH has an A1 rating.

McLeod Health’s outlook was revised to positive from stable by Fitch. The Florence, S.C.-based system was noted for successful strategic growth and strong operating results despite labor and inflation pressure. Fitch also said McLeod’s adjusted leverage shows ample flexibility. The system has an AA- rating.

Med Center Health’s outlook was revised to positive from stable by Fitch. The Bowling Green, Ky.-based system was cited for 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.

Methodist Hospitals’ outlook was revised to stable from negative by Fitch. The Gary, Ind.-based system was cited for recently improved supplemental Disproportionate Share Hospital payments and Fitch’s expectation that the payment stream will remain strong going forward. The system has a BBB- rating.

Northern Light Health’s outlook was revised to stable from negative by Moody’s. The Brewer, Maine-based system was described as being in an ongoing financial turnaround that has reduced operating losses and stabilized cash reserves. Moody’s said Northern Light has a Ba3 rating.

RWJBarnabas Health’s outlook was revised to positive from stable by Moody’s. The West Orange, N.J.-based system was recognized for strengthened financial and operating performance and rising cash reserves. Moody’s said those improvements are taking place amid substantial capital investments and reflect a highly effective financial strategy and risk management approach.

South Shore Health’s outlook was revised to stable from negative by Moody’s. The South Weymouth, Mass.-based system was cited for quarterly improvement in financial performance. Moody’s said it expects the strong margins demonstrated in the first quarter of fiscal 2026 to be sustained. The system has a Baa2 rating.

Tallahassee (Fla.) Memorial HealthCare’s outlook was revised to positive from stable by Moody’s. The revision was driven by operational and liquidity improvement, along with the formalization of its relationship with Tallahassee-based Florida State University. Moody’s said the relationship will support notable capital capacity and market growth. The system has a Baa1 rating.

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

Valleywise Health’s outlook was revised to positive from stable by Fitch. The Phoenix-based system was cited for a financial turnaround in fiscal 2025 that continued into fiscal 2026. Fitch said the improvement was driven by a full year of the Safety Net Services Initiative and improved labor cost management. Valleywise has a BBB rating.

Vandalia Health’s outlook was revised to stable from negative by Moody’s. The Charleston, W.Va.-based system was credited with improved cash flow supported by new directed payment program funds. Moody’s also said it expects balance sheet measures to build from currently modest levels. Vandalia has a Baa1 rating with the agency.

Across the group, the outlook changes point to a mix of operational improvement, stronger liquidity and support from state or program funding. Some revisions also reflected capital projects, strategic growth or balance sheet progress that rating agencies believe could help support performance going forward. The source did not report additional details beyond the outlook actions, rating levels and the factors cited by Fitch or Moody’s.