Fitch Ratings affirmed HCA Healthcare Inc.'s ratings, including the hospital operator's long-term issuer default rating at BB.
The outlook on the rating is stable.
Fitch said the rating and outlook reflects the health care services provider's good financial flexibility, stable leverage, profitability and free cash flow generation compared to four publicly traded hospital operator peers.
The rating agency believes Nashville, Tenn.-based HCA has limited financial incentive to operate with leverage sustained below 3.5x. Fitch sees the company producing cash flow from operations of $6.3 billion in 2019, about the same as the prior year.
Fitch expects the company's organic revenue to grow by 4% to 5% from 2019 to 2022 driven equally by pricing and volume.