ML Analysis — BOONE HOSPITAL CENTER
CCN 260068 | 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.
58
/ 100 (C)
Financial Health7/25
RCM Upside19/25
Market Position13/20
Demand Defensibility14/15
Operational Efficiency4/15
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
- Strong commercial payer base protects revenue
Margin Prediction (Trained Ridge Model)
-9.3%
R²=0.34 | n=4,907 | Grade B | Actual: -22.4%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-37.6%, 19.0%]. P39 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 1246502.745 | -0.0465 | Lower Revenue/Bed decreases predicted margin | |
| Log(Beds) | 5.628 | +0.0291 | Higher Log(Beds) increases predicted margin | |
| Bed Count | 278.000 | -0.0202 | Higher Bed Count decreases predicted margin | |
| Expense/Bed | 1526363.306 | +0.0161 | Higher Expense/Bed increases predicted margin | |
| State Peer Margin | -0.062 | -0.0125 | Lower State Peer Margin decreases predicted margin |
Turnaround: 34%Turnaround possible (34%) but uncertain. Margin improvement depends on improving Revenue/Bed.
Under-Performing / Distre
Archetype
47.5%
Distress Risk
$2.9M
RCM Opportunity
D
Opportunity Grade
-21.6%
Projected Margin
Cluster: Under-Performing / Distressed
Percentile within cluster: P63. 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: Elevated
National distress rate: 49.3%
MO distress rate: 53.0%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.572 | -0.044 | ▼ risk |
| Medicaid Day Pct | 0.047 | -0.042 | ▼ risk |
| Net To Gross Ratio | 0.295 | -0.033 | ▼ risk |
| Revenue Per Bed | 1246502.745 | +0.020 | ▲ risk |
| Beds | 278.000 | +0.017 | ▲ risk |
| Medicare Day Pct | 0.387 | +0.010 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $2.9M
Current margin: -22.4%
Projected margin: -21.6%
Grade: D
Comps: 34
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Payer Mix Optimization | 0.566 | 0.684 | 11.7% | $1.8M | 50% | 24mo |
| Occupancy Improvement | 0.572 | 0.743 | 17.0% | $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. |