ML Analysis — TUFTS MEDICAL CENTER
CCN 220116 | Clustering + Distress + RCM Opportunity
🛡️ Public data only — no PHI permitted on this instance.
Investability Score
Hold / Selective — investigate specific opportunities but be prepared for execution risk.
56
/ 100 (C)
Financial Health9/25
RCM Upside20/25
Market Position7/20
Demand Defensibility15/15
Operational Efficiency6/15
Entry Multiple: 9.5x – 11.5x
Est. MOIC: 2.3x
Risk Factors:
- Negative operating margin
- Expenses exceed revenue
Catalysts:
- RCM optimization could add 3-5pp margin
Margin Prediction (Trained Ridge Model)
-20.5%
R²=0.34 | n=4,907 | Grade B | Actual: -49.1%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-48.9%, 7.8%]. P20 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 3173997.403 | -0.1869 | Higher Expense/Bed decreases predicted margin | |
| Revenue/Bed | 2128659.333 | +0.0767 | Higher Revenue/Bed increases predicted margin | |
| State Peer Margin | -0.122 | -0.0566 | Lower State Peer Margin decreases predicted margin | |
| Bed Count | 385.000 | -0.0369 | Higher Bed Count decreases predicted margin | |
| Log(Beds) | 5.953 | +0.0367 | Higher Log(Beds) increases predicted margin |
Turnaround: 19%Low turnaround probability (19%). Structural disadvantages in Expense/Bed and Revenue/Bed.
Safety-Net/Medicaid Heavy
Archetype
50.3%
Distress Risk
$20.7M
RCM Opportunity
D
Opportunity Grade
-46.6%
Projected Margin
Cluster: Safety-Net/Medicaid Heavy
Percentile within cluster: P92. High Medicaid dependence creates reimbursement risk. Assess DSH payments and state expansion status.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| WESTERN PEAKS SPECIALTY HOSPITAL | UT | 59 |
| HOSPITAL MENONITA AIBONITO | PR | 129 |
| TOPPENISH COMMUNITY HOSPITAL | WA | 47 |
| MINERAL COMMUNITY HOSPITAL | MT | 25 |
| BANNER UNIVERSITY MED CENTER SOUTH | AZ | 132 |
| NORTH COLORADO MEDICAL CENTER | CO | 202 |
Distress Analysis
Risk: High
National distress rate: 49.3%
MA distress rate: 61.8%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Medicaid Day Pct | 0.294 | +0.205 | ▲ risk |
| Occupancy Rate | 0.704 | -0.166 | ▼ risk |
| Revenue Per Bed | 2128659.332 | -0.032 | ▼ risk |
| Beds | 385.000 | +0.032 | ▲ risk |
| Medicare Day Pct | 0.406 | +0.014 | ▲ risk |
| Net To Gross Ratio | 0.340 | -0.013 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $20.7M
Current margin: -49.1%
Projected margin: -46.6%
Grade: D
Comps: 25
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Net-to-Gross Ratio Improvement | 0.340 | 0.494 | 15.4% | $14.8M | 65% | 18mo |
| Payer Mix Optimization | 0.300 | 0.599 | 29.8% | $4.5M | 50% | 24mo |
| Occupancy Improvement | 0.704 | 0.922 | 21.8% | $1.4M | 55% | 24mo |
Predicted RCM Performance (Public Data Only)
A
RCM Grade
Strong RCM profile — likely low-risk from an operations perspective. Focus diligence on growth thesis.
| Metric | Predicted | 90% CI | Percentile | Assessment |
|---|---|---|---|---|
| Denial Rate | 2.0% | [2.0%, 25.0%] | P0 | Strong — predicted denial rate is in the top third nationall |
| Days in AR | 26.8 | [25.0, 75.0] | P38 | Strong — predicted days in ar is in the top third nationally |
| Clean Claim Rate | 98.0% | [80.0%, 98.0%] | P0 | Strong — predicted clean claim rate is in the top third. |
| Net Collection Rate | 99.5% | [90.0%, 99.5%] | P8 | Strong — predicted net collection rate is in the top third. |