LifePoint Hospitals hopes that folks who get sick in the country won't head to the city to get well. The company operates 56 hospitals located in non-urban areas. In most cases, the hospitals (which house more than 6,000 beds combined) are the only available acute care facilities in the region. LifePoint operates its hospitals in 18 states through subsidiaries, with the heaviest concentrations in Kentucky, Tennessee, Virginia, Alabama, and Louisiana. In many markets, the company also operates outpatient clinics that provide family care, diagnostic, surgical, and therapeutic services. Unlike major urban medical centers, the hospitals that LifePoint operates don't usually engage in extensive medical research, train legions of new doctors, or perform complex surgeries. The facilities do provide a spectrum of health care services that include emergency care, general surgery, obstetrics, oncology, cardiology, and diagnostic care. LifePoint maintains a competitive edge in many of its regional markets by being the sole provider in the community of many of the health care services it offers. Even so, LifePoint is working to increase the breadth of services provided by its hospitals in an effort to keep patients from having to travel outside the community for care, especially in specialty areas such as open-heart surgery, psychiatric care, and neurosurgery. To achieve this end, the company is improving methods of recruiting and retaining doctors; it is also investing in system-wide capital improvement projects and technology upgrades. In addition to organic growth measures, LifePoint also expands through regular acquisitions. The company targets small, non-urban hospitals where it sees an opportunity for improved financial performance, and LifePoint typically invests in facility upgrades once its purchases are complete. Purchases in 2010 include the 100-bed Clark Regional Medical Center in Winchester, Kentucky, and the financially troubled Sumner Regional Health Systems (now HighPoint Health System, which operates the 155-bed Sumner Regional Medical Center) in north-central Tennessee. In 2012 it acquired the 72-bed Woods Memorial Hospital in Etowah, Tennessee. Woods provides inpatient and outpatient services and its campus includes 88-bed McMinn Memorial Nursing Home, which is licensed to provide long-term and skilled nursing care. In early 2011 LifePoint formed a joint venture with Duke University Health System to provide management and cost-control services to community hospitals looking for operational support in the face of increasing competition and health reform changes. The venture, named Duke LifePoint Healthcare, subsequently gained control of two small North Carolina hospitals, Maria Parham Medical Center (80% owned) and Person Memorial Hospital (wholly owned). Duke LifePoint has committed funds for capital improvements at both facilities. The venture also acquired the North Carolina cardiac catheterization business of MedCath Partners that year and renamed it DLP Cardiac Partners, and in 2012 it purchase an 80% stake in Twin County Regional, a 140-bed hospital in Galax, Virginia. To free up more funds to invest in its growth strategies, LifePoint works to control expenses in all areas of the organization. One of its technology initiatives is to invest in electronic health record (EHR) systems under federal health reform guidelines, which aim to lower the cost of care through measures such as eliminating redundant procedures and lowering readmission rates. The company also manages procurement expenses by participating (and owning a 4% stake) in the HealthTrust Purchasing Group, a group purchasing organization that negotiates competitive contracts on medical supplies and equipment. LifePoint also struggles with containing expenses from serving charity care and self-pay customers that are part and parcel of running a health care system. To help offset losses related to caring for uninsured patients, the company strives to negotiate favorable contracts with managed care and other private payers at each of its facilities. More than 40% of LifePoint's annual revenues come from private insurers (including HMO and PPO plans), while another 40% come from Medicare and Medicaid. About 15% of revenues come from self-pay patients, which are uninsured accounts that may not be collected. As its self-pay numbers have risen in recent years due to economic conditions, the company has had to increase provisions for doubtful accounts (unpaid medical bills). In 2011 the company changed how its reports these doubtful account provisions, which resulted in a 7% drop in annual revenues to a little over $3 billion (down from nearly $3.3 billion in 2010). However, despite continued uncertainty over how economic conditions and health reform measure will impact its business in the coming years, LifePoint has managed to continue to increase its profits. The firm showed a 5% increase in net income in 2011 to some $163 million. LifePoint was born when hospital giant HCA spun off a group of about two dozen hospitals in 1999. It wasn't its 2005 merger with Province Healthcare Company that LifePoint became the hulking presence it is today.