Community Health Systems (CHS) said its second quarter was hit hard by a surge in uninsured and self‑pay patients and slower insurer payments, sending profits sharply lower and prompting a pullback in its hospital footprint. Key points - Financials: CHS reported operating income of $389 million (13.8% margin) in Q2, down from $512 million (16.3%) a year earlier. After interest and taxes, net income fell to $70 million (a 2.5% margin) — a roughly 75% year‑over‑year decline. (Becker’s) - Footprint: The company’s hospital count has dropped to 60. (Becker’s) - Payer mix and self‑pay: Executives said an unfavorable change in payer mix — principally a rapid rise in uninsured and self‑pay patients, many tied to ACA exchange churn and disenrollment — materially eroded revenue and margins. CHS’s CEO warned self‑pay cases are worth only “pennies on the dollar,” squeezing profitability. (Becker’s; Healthcare Dive) - Revenue cycle and cash flow: CHS CFO Jason Johnson said insurers’ increased pre‑payment audits and slower claims payments are stretching accounts receivable days and slowing cash collections. (Becker’s) - Industry context: CHS missed Q2 earnings and revenue expectations and noted the payer‑mix issue mirrors trends seen at other for‑profit hospital operators. (Fierce Healthcare) Sources: Becker’s Hospital Review (finance and revenue‑cycle pieces), Fierce Healthcare, Healthcare Dive. Links: - https://www.beckershospitalreview.com/finance/chs-q2-profit-down-75-as-hospital-footprint-falls-to-60-7-things-to-know/ - https://www.fiercehealthcare.com/providers/community-health-systems-misses-q2-earnings-revenue - https://www.beckershospitalreview.com/finance/revenue-cycle-management/payer-pre-payment-audits-are-stretching-chss-a-r-days-cfo-says/ - https://www.beckershospitalreview.com/finance/pennies-on-the-dollar-chs-ceo-warns-self-pay-surge-is-crushing-margins/ - https://www.healthcaredive.com/news/rise-uninsured-patients-hits-chs-finances-q2-2026/826021/