MERCY HOSPITAL OKC
1. Target Overview & Investment Thesis
MERCY HOSPITAL OKC is a 344-bed suburban community hospital in OKLAHOMA, OK with $674.3M in net patient revenue and a 10.5% operating margin. The hospital serves a payer mix of 26.5% Medicare, 21.4% Medicaid, and 52.1% commercial.
Thesis: Platform Growth. Our ML models identify $49.6M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 10.5% to 17.9% (+736bps).
| Net Revenue HCRIS | $674.3M |
| Current EBITDA COMPUTED | $70.9M |
| Operating Margin COMPUTED | 10.5% |
| Occupancy HCRIS | 67.1% |
| Revenue / Bed COMPUTED | $2.0M |
| Net-to-Gross HCRIS | 24.7% |
| Distress Probability ML | 47.5% |
2. Market Context & Competitive Position
OK has 147 Medicare-certified hospitals with a median operating margin of -8.8%. The target's margin of 10.5% places it above the state median. Among 1361 size-comparable peers (172-688 beds), the median margin is -3.8%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (172-688), prioritizing same-state peers. 1361 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| MERCY HOSPITAL OKC (Target) | OK | 344 | $674.3M | 10.5% |
| ST. LUKES HOSPITAL | PA | 633 | $8.94B | 87.9% |
| STANFORD HEALTH CARE | CA | 657 | $6.76B | 3.7% |
| MEMORIAL HOSPITAL FOR CANCER A | NY | 514 | $4.34B | -32.5% |
| UC DAVIS MEDICAL CENTER | CA | 666 | $3.28B | -11.5% |
| U OF U HOSPITALS & CLINICS | UT | 616 | $2.72B | -1.8% |
| THE CHILDRENS HOSPITAL OF PHIL | PA | 667 | $2.70B | -26.8% |
| UNIVERSITY OF WI HOSPITALS & C | WI | 644 | $2.68B | 3.2% |
| RONALD REAGAN UCLA | CA | 446 | $2.62B | -6.8% |
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: $49.6M (736bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $14.2M | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $13.5M | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $13.4M | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $8.2M | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $432K | +6bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $70.9M |
| + RCM Uplift | +$49.6M |
| Pro Forma EBITDA | $120.5M |
| Current Margin | 10.5% |
| Pro Forma Margin | 17.9% |
| WC Released (1x) | $25.9M |
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 | $109.1M | $963.9M | 8.84x | 54.6% |
| Base (11x exit) | 10.0x | 11.0x | $109.1M | $1.10B | 10.05x | 58.6% |
| Bull Case | 9.0x | 11.0x | $98.2M | $1.29B | 13.19x | 67.5% |
| Bull (12x exit) | 9.0x | 12.0x | $98.2M | $1.44B | 14.69x | 71.2% |
| Bear Case | 11.0x | 10.0x | $120.0M | $680.3M | 5.67x | 41.5% |
| Bear (11x exit) | 11.0x | 11.0x | $120.0M | $787.3M | 6.56x | 45.7% |
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
- 1361 hospitals with 172-688 beds
- Same-state prioritization (n=8)
- Comp margins: P25=-13.2% / P50=-3.8% / P75=5.5%
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.