Industry
Fitch, Moody's Downgrade 20 Hospitals on Financial Strain in 2026
Becker's Hospital Review compiles 20 hospitals and health systems that received credit rating downgrades from Fitch Ratings or Moody's Investors Service in 2026, citing rising expenses, operating losses and liquidity pressures. Several downgrades, including Children's Hospital Los Angeles, directly cite heavy reliance on state Medicaid funding and Medicaid exposure as drivers of weak operations and liquidity. Other systems, such as Boston Medical Center, point to state payment reliance and health plan volatility constraining their ability to rebuild cash reserves. The list spans academic medical centers, children's hospitals, and community systems facing capital project costs, physician acquisition spending, and declining surgical volumes.
Why it mattersCredit downgrades tied to Medicaid reliance signal deepening financial fragility among safety-net and children's hospitals that state Medicaid agencies depend on for access, raising risk of service cuts or closures if state payment levels don't improve.