Hospital Chain's Rural Focus Gives It An Edge; Health Mgmt. Associates Inc.; Naples, Fla. hma-corp.com.(HEALTH & MEDICINE)(UNDER THE MICROSCOPE)

Byline: Gloria Lau

The hospital industry has had its share of ups and downs the past decade. But through it all, Health Management Associates keeps delivering financial growth.

The hospital chain has posted 14 straight years of annual earnings gains. Its earnings have grown at least in double digits each of those years except 1999.

In contrast, the industry's two largest players -- HCA Inc. and Tenet Healthcare Corp. -- each suffered earnings or revenue declines in four of the past 14 years.

Part of Health Management's success is due to its strategy of avoiding big cities. The company, also known as HMA, is the nation's biggest operator of rural hospitals. Sixty percent of its hospitals are the only game in town. Thirty percent have just one local hospital rival.

"There's not a lot of competition in Durant, Okla.," said John Merriwether, HMA's vice president of financial relations.

HMA operates 52 hospitals in 16 states with 7,540 licensed beds. The company avoids towns where one industry or employer dominates because that can weaken a hospital's negotiating power. And it steers clear of towns where an industry downturn could hurt hospital revenue.