ML Analysis — COXHEALTH
CCN 260040 | 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.
54
/ 100 (C)
Financial Health8/25
RCM Upside19/25
Market Position13/20
Demand Defensibility10/15
Operational Efficiency4/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Expenses exceed revenue
Catalysts:
- RCM optimization could add 3-5pp margin
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-12.9%
R²=0.34 | n=4,907 | Grade B | Actual: -7.6%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-41.2%, 15.4%]. P31 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Bed Count | 791.000 | -0.1002 | Higher Bed Count decreases predicted margin | |
| Log(Beds) | 6.673 | +0.0534 | Higher Log(Beds) increases predicted margin | |
| Expense/Bed | 1875122.561 | -0.0268 | Higher Expense/Bed decreases predicted margin | |
| Revenue/Bed | 1741964.442 | +0.0227 | Higher Revenue/Bed increases predicted margin | |
| State Peer Margin | -0.062 | -0.0125 | Lower State Peer Margin decreases predicted margin |
Turnaround: 29%Low turnaround probability (29%). Structural disadvantages in Bed Count and Log(Beds).
Large Academic Medical Ce
Archetype
49.9%
Distress Risk
$5.6M
RCM Opportunity
D
Opportunity Grade
-7.2%
Projected Margin
Cluster: Large Academic Medical Center
Percentile within cluster: P27. Large medical centers trade at premium multiples (12-14x). Limited PE value creation but strong cash flow.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| NORTH CAROLINA BAPTIST HOSPITAL | NC | 800 |
| HACKENSACK UNIVERSITY MEDICAL CENTER | NJ | 779 |
| TEMPLE UNIVERSITY HOSPITAL | PA | 761 |
| VCU HEALTH SYSTEM MCV HOSPITAL | VA | 842 |
| UH CLEVELAND MEDICAL CENTER | OH | 660 |
| FROEDTERT MEM. LUTHERAN HOSPT. | WI | 731 |
Distress Analysis
Risk: Elevated
National distress rate: 49.3%
MO distress rate: 53.0%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Beds | 791.000 | +0.086 | ▲ risk |
| Medicaid Day Pct | 0.157 | +0.068 | ▲ risk |
| Occupancy Rate | 0.591 | -0.061 | ▼ risk |
| Net To Gross Ratio | 0.286 | -0.037 | ▼ risk |
| Medicare Day Pct | 0.192 | -0.023 | ▼ risk |
| Revenue Per Bed | 1741964.442 | -0.010 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $5.6M
Current margin: -7.6%
Projected margin: -7.2%
Grade: D
Comps: 10
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 | 0.286 | 0.306 | 2.0% | $3.2M | 65% | 18mo |
| Payer Mix Optimization | 0.651 | 0.737 | 8.6% | $1.3M | 50% | 24mo |
| Occupancy Improvement | 0.591 | 0.756 | 16.5% | $1.1M | 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 | 25.0 | [25.0, 75.0] | P0 | 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. |