OKC-AMG SPECIALTY HOSPITAL
1. Target Overview & Investment Thesis
OKC-AMG SPECIALTY HOSPITAL is a 18-bed suburban community hospital in OKLAHOMA, OK with $14.4M in net patient revenue and a 26.6% operating margin. The hospital serves a payer mix of 76.2% Medicare, 7.3% Medicaid, and 16.5% commercial.
Thesis: Turnaround. Our ML models identify $1.1M in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 26.6% to 34.0% (+737bps).
| Net Revenue HCRIS | $14.4M |
| Current EBITDA COMPUTED | $3.8M |
| Operating Margin COMPUTED | 26.6% |
| Occupancy HCRIS | 88.2% |
| Revenue / Bed COMPUTED | $800K |
| Net-to-Gross HCRIS | 51.6% |
| Distress Probability ML | 44.9% |
2. Market Context & Competitive Position
OK has 147 Medicare-certified hospitals with a median operating margin of -8.8%. The target's margin of 26.6% places it above the state median. Among 65 size-comparable peers (9-36 beds), the median margin is -18.0%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (9-36), prioritizing same-state peers. 65 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| OKC-AMG SPECIALTY HOSPITAL (Target) | OK | 18 | $14.4M | 26.6% |
| OKLAHOMA SPINE HOSPITAL | OK | 23 | $79.0M | 8.4% |
| BAILEY MEDICAL CENTER | OK | 33 | $54.6M | 13.3% |
| BRISTOW MEDICAL CENTER | OK | 25 | $48.5M | -12.6% |
| INTEGRIS MIAMI HOSPITAL | OK | 36 | $43.3M | -32.1% |
| JEFFERSON COUNTY HOSPITAL | OK | 25 | $41.1M | 14.4% |
| PHYSICIANS HOSPITAL AT ANADARK | OK | 25 | $34.1M | -48.1% |
| LAKESIDE WOMENS HOSPITAL | OK | 23 | $33.0M | 16.5% |
| STROUD REGIONAL MEDICAL CENTER | OK | 25 | $31.4M | -50.0% |
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: $1.1M (737bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $302K | +210bp | 18mo |
| Cost to Collect | 4.5% | 2.5% | $288K | +200bp | 12mo |
| Denial Rate Reduction | 12.0% | 6.5% | $285K | +198bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $175K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $10K | +7bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $3.8M |
| + RCM Uplift | +$1.1M |
| Pro Forma EBITDA | $4.9M |
| Current Margin | 26.6% |
| Pro Forma Margin | 34.0% |
| WC Released (1x) | $552K |
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 | $5.9M | $35.9M | 6.09x | 43.5% |
| Base (11x exit) | 10.0x | 11.0x | $5.9M | $41.4M | 7.02x | 47.7% |
| Bull Case | 9.0x | 11.0x | $5.3M | $46.8M | 8.82x | 54.6% |
| Bull (12x exit) | 9.0x | 12.0x | $5.3M | $52.6M | 9.92x | 58.2% |
| Bear Case | 11.0x | 10.0x | $6.5M | $28.6M | 4.42x | 34.6% |
| Bear (11x exit) | 11.0x | 11.0x | $6.5M | $33.6M | 5.19x | 39.0% |
7. Key Risks & Mitigants
| Severity | Risk Factor | Mitigant |
|---|---|---|
| Medium | Heavy Medicare dependence | Medicare comprises 76.2% of days; rate updates may lag inflation. Mitigant: CDI/CMI lever directly increases Medicare reimbursement |
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
- 65 hospitals with 9-36 beds
- Same-state prioritization (n=69)
- Comp margins: P25=-30.1% / P50=-18.0% / P75=-4.7%
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.