Given virus containment measures resulting in the deferral of elective procedures, we think there will be a reduction in claims volume leading to pressure on Zelis Holdings L.P.'s profitability in 2020. We are revising our outlook on Zelis to negative from stable, while affirming our 'B' issuer credit rating on the company and our 'B' debt rating on its first-lien credit facility. The negative outlook reflects the high degree of uncertainty regarding the depth and duration of the pandemic, its implications on claims volumes, and how it could affect Zelis' operating performance and deleveraging efforts. On April 6, 2020, S&P Global Ratings revised its outlook on Zelis Holdings L.P. to negative from stable. At the same time, we affirmed our
