Fitch Ratings affirmed HCA Healthcare Inc.'s long-term issuer default rating at BB.

The outlook on the rating is stable.

Fitch said the BB rating reflects HCA's good financial flexibility with moderate financial leverage relative to five publicly traded hospital operator peers, industry leading profitability and free cash flow generation.

The rating agency expects HCA's organic revenue to grow slightly less than 4% in 2017 and 2018, driven equally by growth in pricing and patient volumes.