ML Analysis — BEARTOOTH BILLINGS CLINIC
CCN 271326 | 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.
49
/ 100 (C)
Financial Health4/25
RCM Upside19/25
Market Position14/20
Demand Defensibility6/15
Operational Efficiency6/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Small facility (<50 beds) — limited scale
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-11.2%
R²=0.34 | n=4,907 | Grade B | Actual: -6.6%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-39.5%, 17.1%]. P34 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Log(Beds) | 2.303 | -0.0481 | Lower Log(Beds) decreases predicted margin | |
| Expense/Bed | 1960579.600 | -0.0374 | Higher Expense/Bed decreases predicted margin | |
| State Peer Margin | -0.096 | -0.0373 | Lower State Peer Margin decreases predicted margin | |
| Revenue/Bed | 1838792.800 | +0.0362 | Higher Revenue/Bed increases predicted margin | |
| Net-to-Gross | 0.589 | +0.0247 | Higher Net-to-Gross increases predicted margin |
Turnaround: 31%Turnaround possible (31%) but uncertain. Margin improvement depends on improving Log(Beds).
Rural/Critical Access
Archetype
52.6%
Distress Risk
$302K
RCM Opportunity
D
Opportunity Grade
-5.0%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P24. Rural/small hospitals face structural headwinds. Evaluate CAH conversion, telehealth, and rural health funding.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| BRECKINRIDGE HEALTH INC | KY | 25 |
| SHERIDAN MEMORIAL HOSPITAL | MT | 19 |
| DAYTON GENERAL HOSPITAL | WA | 25 |
| BLUE MOUNTAIN HOSPITAL DISTRICT | OR | 16 |
| COMMUNITY HOSPITAL | WY | 25 |
| CARLE EUREKA HOSPITAL | IL | 25 |
Distress Analysis
Risk: High
National distress rate: 49.3%
MT distress rate: 69.8%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Net To Gross Ratio | 0.589 | +0.098 | ▲ risk |
| Occupancy Rate | 0.456 | +0.065 | ▲ risk |
| Medicare Day Pct | 0.547 | +0.038 | ▲ risk |
| Medicaid Day Pct | 0.054 | -0.035 | ▼ risk |
| Beds | 10.000 | -0.019 | ▼ risk |
| Revenue Per Bed | 1838792.800 | -0.015 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $302K
Current margin: -6.6%
Projected margin: -5.0%
Grade: D
Comps: 13
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 | 0.589 | 0.729 | 14.0% | $302K | 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 | 31.5 | [25.0, 75.0] | P67 | 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. |