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Extensive Size and Revenue Diversity: CommonSpirit's revenue defensibility is supported by its broad revenue composition, ranging across different services and markets. Its revenue defensibility is midrange, which is ���������ֳ�'s most favorable assessment without meaningful taxing authority. ���������ֳ� defines revenue defensibility as an organization's ability to influence future reimbursement levels through volume or rate increases. Providers are more limited than in other municipal sectors due to Medicare, Medicaid and self-pay volumes, which constrain a provider's ability to increase future reimbursement rates. Medicaid represents just 21.2% of gross patient revenues and self-pay represents 3.0% of gross patient revenues. The payor mix has been stable at these levels, and ���������ֳ� does not expect any significant changes in the coming years. Revenue defensibility also depends on the organization's market share and market position, along with the economic outlook of the organization's service area(s). Many CommonSpirit hospitals are in high growth, competitive markets where they command a leading or very solid market share. Aside from its broad geographic diversity, the system exhibits revenue diversity from a portfolio that includes a wide array of acute and non-acute healthcare services. Across its markets, CommonSpirit has a combined payor mix comprising 24.2% of gross revenues derived from Medicaid and self-pay, which is factored into the midrange revenue defensibility assessment. CommonSpirit has not experienced a significant shift in payor mix; however, as with most in the sector, CommonSpirit will likely seek rate increases from commercial payors given the pattern of rising staffing and overall system costs.