Non-profit hospitals should experience a relatively stable 2019, according to S&P Global Financial.

The bond-rating company estimates that 81 percent of such hospitals will be stable this year, with roughly equal numbers of hospitals looking at upgrades and downgrades.

This stability is being driven by strong balance sheets and diversification while challenges to hospital financial performance and stability include the possibility of a recession, rising costs for serving an aging population, changes in Medicaid eligibility and payment policies, and the continued emergence of non-traditional health care providers.

S&P also concludes that hospital operating margins are recovering after years of investment in information technology and electronic health records systems.  Most non-profit hospitals face a growing dependence on government payers at the same time that the adequacy of payments from commercial insurers weakens.

Learn more from the S&P Global Ratings report “U.S. Not-For-Profit Health Care 2019 Sector Outlook: Stable Overall, Yet Key Risks Remain.”