Community Health Systems (NYSE:CYH) owns and leases over a hundred hospitals in 29 states, primarily in rural communities.^[1] While the company's growth is partially organic, the bulk of revenue increases have resulted from acquisitions, such as the purchase of Triad Hospitals Inc. which doubled the size of the CYH network, in terms of beds, and made it the largest publicly traded hospital operator chain in the country. The company earned $12 billion in revenue and $243 million in net income in 2009.^[2]

As U.S. demographics change - and trend toward urban or rural relocations - so do CYH's revenues. Population size and economic cycles help determine the number of potential patients living close to CYH's hospitals and the amount of healthcare they need. Medicare and Medicaid laws also impact the company's operating income, and the growing quantitative gap between insured and uninsured and/or underinsured patients are concerns as more private clinics and physician-owned hospitals attract the most expensive and specialized medical procedures funded by private insurance. To stave off competition from these smaller, more nimble providers, the firm often forms partnerships with them.

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