Explore Kaufman Hall’s Capital Playbook for health systems, a guide to prioritizing investments, optimizing funding strategies, and strengthening financial resilience in a shifting healthcare environment.

Hospital rating downgrades declined in 2025 while the number of upgrades increased, resulting in a lower ratio of downgrades to upgrades and tempering higher downgrade activity in recent years.

From managing non-labor expenses to strengthening the workforce, expanding access and navigating payer reimbursement, health systems shared the key challenges shaping their focus this year—and their planning for the year ahead.

The latest Kaufman Hall Report includes highlights from the annual Healthcare Leadership Conference.

Healthcare sector delivers best-performing quarter, affordability crisis deepens, CMS proposes Medicare Advantage star ratings overhaul

The answer to “why weren’t we downgraded” is multifaceted and will depend on each hospital’s circumstances. But there are often three factors at play, including rating tolerance, the role of medians and effective messaging.