ML Analysis — INSIGHT SURGICAL HOSPITAL
CCN 230264 | Clustering + Distress + RCM Opportunity
🛡️ Public data only — no PHI permitted on this instance.
Investability Score
Speculative — only pursue if turnaround thesis is strong and entry multiple reflects risk.
40
/ 100 (D)
Financial Health3/25
RCM Upside19/25
Market Position13/20
Demand Defensibility2/15
Operational Efficiency4/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Small facility (<50 beds) — limited scale
- Low occupancy (<30%) — demand risk
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
Margin Prediction (Trained Ridge Model)
-12.8%
R²=0.34 | n=4,907 | Grade B | Actual: -8.5%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-41.1%, 15.5%]. P31 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 2358322.462 | -0.0864 | Higher Expense/Bed decreases predicted margin | |
| Revenue/Bed | 2174274.385 | +0.0831 | Higher Revenue/Bed increases predicted margin | |
| Log(Beds) | 2.565 | -0.0420 | Lower Log(Beds) decreases predicted margin | |
| Net-to-Gross | 0.128 | -0.0269 | Lower Net-to-Gross decreases predicted margin | |
| Reimbursement Quality | 0.114 | +0.0252 | Higher Reimbursement Quality increases predicted m |
Turnaround: 29%Low turnaround probability (29%). Structural disadvantages in Expense/Bed and Revenue/Bed.
Under-Performing / Distre
Archetype
52.1%
Distress Risk
$3.5M
RCM Opportunity
B
Opportunity Grade
4.0%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P89. Deeply negative margins signal severe distress. Evaluate asset-level acquisition at 4-6x normalized EBITDA.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| HOLY FAMILY MEMORIAL INC | WI | 58 |
| MIDDLESBORO ARH | KY | 46 |
| ATRIUM HEALTH NAVICENT BALDWIN | GA | 86 |
| BON SECOURS COMMUNITY HOSPITAL | NY | 98 |
| ADVANCED SPECIALTY HOSP. OF TOLEDO | OH | 40 |
| COMMUNITY HEALTH CENTER BRANCH | MI | 75 |
Distress Analysis
Risk: High
National distress rate: 49.3%
MI distress rate: 50.9%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.103 | +0.391 | ▲ risk |
| Net To Gross Ratio | 0.128 | -0.107 | ▼ risk |
| Medicaid Day Pct | 0.006 | -0.083 | ▼ risk |
| Medicare Day Pct | 0.108 | -0.038 | ▼ risk |
| Revenue Per Bed | 2174274.385 | -0.035 | ▼ risk |
| Beds | 13.000 | -0.018 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $3.5M
Current margin: -8.5%
Projected margin: 4.0%
Grade: B
Comps: 43
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.103 | 0.407 | 30.3% | $2.0M | 55% | 24mo |
| Net-to-Gross Ratio Improvement | 0.128 | 0.587 | 45.9% | $1.5M | 65% | 18mo |
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 | 36.3 | [25.0, 75.0] | P80 | Average — predicted days in ar is near the median. |
| Clean Claim Rate | 98.0% | [80.0%, 98.0%] | P0 | Strong — predicted clean claim rate is in the top third. |
| Net Collection Rate | 98.6% | [90.0%, 99.5%] | P2 | Strong — predicted net collection rate is in the top third. |