ALBUQUERQUE - AMG SPECIALTY HOSPITAL
1. Target Overview & Investment Thesis
ALBUQUERQUE - AMG SPECIALTY HOSPITAL is a 32-bed community hospital in BERNALILLO, NM with $20.2M in net patient revenue and a 29.9% operating margin. The hospital serves a payer mix of 29.7% Medicare, 0.0% Medicaid, and 70.3% commercial.
Thesis: Turnaround. Our ML models identify $1.5M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 29.9% to 37.2% (+736bps).
| Net Revenue HCRIS | $20.2M |
| Current EBITDA COMPUTED | $6.0M |
| Operating Margin COMPUTED | 29.9% |
| Occupancy HCRIS | 84.2% |
| Revenue / Bed COMPUTED | $630K |
| Net-to-Gross HCRIS | 49.7% |
| Distress Probability ML | nan% |
2. Market Context & Competitive Position
NM has 55 Medicare-certified hospitals with a median operating margin of -2.7%. The target's margin of 29.9% places it above the state median. Among 30 size-comparable peers (16-64 beds), the median margin is -3.2%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (16-64), prioritizing same-state peers. 30 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| ALBUQUERQUE - AMG SPECIALTY HO (Target) | NM | 32 | $20.2M | 29.9% |
| NOR-LEA HOSPITAL | NM | 25 | $131.5M | 0.9% |
| UNM SANDOVAL REGIONAL MEDICAL | NM | 60 | $104.5M | -11.9% |
| CARLSBAD MEDICAL CENTER | NM | 53 | $97.1M | 19.9% |
| SANTA FE MEDICAL CENTER | NM | 36 | $95.0M | -26.5% |
| GILA REGIONAL MEDICAL CENTER | NM | 25 | $83.6M | -3.6% |
| HOLY CROSS HOSPITAL | NM | 25 | $72.9M | -20.0% |
| LINCOLN COUNTY MEDICAL CENTER | NM | 25 | $66.7M | 4.1% |
| LOVELACE REGIONAL HOSPITAL-ROS | NM | 27 | $63.1M | 9.3% |
4. Predicted Improvement Opportunities
Improvement targets set at P75 of comparable peers with 60% gap closure assumption. Coefficients calibrated to published research bands. Total EBITDA uplift: $1.5M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $424K | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $403K | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $399K | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $245K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $13K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $6.0M |
| + RCM Uplift | +$1.5M |
| Pro Forma EBITDA | $7.5M |
| Current Margin | 29.9% |
| Pro Forma Margin | 37.2% |
| WC Released (1x) | $774K |
6. Returns Analysis — Scenario Matrix
5-year hold, 5.5x leverage, 3% organic growth, 10%/yr debt paydown. Base case uses 100% of predicted RCM uplift. Bull case: 130% uplift at lower entry. Bear case: 50% uplift at higher entry.
| Scenario | Entry | Exit | Equity In | Equity Out | MOIC | IRR |
|---|---|---|---|---|---|---|
| Base Case | 10.0x | 10.0x | $9.3M | $54.6M | 5.89x | 42.6% |
| Base (11x exit) | 10.0x | 11.0x | $9.3M | $63.0M | 6.80x | 46.7% |
| Bull Case | 9.0x | 11.0x | $8.3M | $71.0M | 8.51x | 53.4% |
| Bull (12x exit) | 9.0x | 12.0x | $8.3M | $79.9M | 9.58x | 57.1% |
| Bear Case | 11.0x | 10.0x | $10.2M | $44.1M | 4.33x | 34.1% |
| Bear (11x exit) | 11.0x | 11.0x | $10.2M | $51.9M | 5.09x | 38.5% |
7. Key Risks & Mitigants
| Severity | Risk Factor | Mitigant |
|---|---|---|
| Medium | Standard execution risk | RCM improvement requires management buy-in and 12-18 month implementation timeline |
8. Data Sources & Methodology Appendix
Data Sources
- CMS HCRIS Cost Reports (Medicare-certified hospitals)
- CMS Medicare Utilization (DRG-level volumes)
- CMS Chronic Conditions (county-level disease prevalence)
- HCRIS multi-year trend data (financial time series)
Comparable Selection
- 30 hospitals with 16-64 beds
- Same-state prioritization (n=31)
- Comp margins: P25=-23.9% / P50=-3.2% / P75=7.6%
Bridge Methodology
- Targets: P75 of comparable peers (60% gap closure)
- Denial: avoidable share = 35% of delta × NPR
- AR: bad debt coefficient = $0.65 per day per $1K NPR
- NCR: 60% coefficient on collection rate improvement
- CDI: 0.75% of Medicare revenue per 0.01 CMI point
Returns Assumptions
- Leverage: 5.5x entry (84.6% debt / 15.4% equity)
- Organic growth: 3% annual EBITDA growth
- Debt paydown: 10% of principal per year
- Hold period: 5 years
Generated by SeekingChartis on April 26, 2026. All predictions use public data only. Confidence intervals calibrated via split conformal prediction (90% coverage target). This memo is for informational purposes and does not constitute investment advice.