CHICAGO — Moody’s Investors Service last week raised its ratings on St. Louis-based Ascension Health, the country’s largest nonprofit health system, due to its steady fiscal strides even as it navigated challenging mergers, occasional struggles in individual markets, and what has grown to an annual $1.2 billion capital program.

Moody’s upgraded the system’s senior debt to Aa1 from Aa2 and its subordinated debt to Aa2 from Aa3. The system, which operates 73 hospitals in 20 states and the District of Columbia, has a total of $4.3 billion of outstanding debt on its books. Moody’s rates only one other health system at one notch below top marks — Utah-based Intermountain Health Care — and none are rated Aaa.

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