ML Analysis — BIG HORN HOSPITAL
CCN 271338 | 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.
42
/ 100 (D)
Financial Health4/25
RCM Upside20/25
Market Position10/20
Demand Defensibility5/15
Operational Efficiency4/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Small facility (<50 beds) — limited scale
- Expenses exceed revenue
Catalysts:
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-17.4%
R²=0.34 | n=4,907 | Grade B | Actual: -49.5%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-45.7%, 10.9%]. P24 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 708863.833 | -0.1215 | Lower Revenue/Bed decreases predicted margin | |
| Medicaid % | 0.755 | -0.0806 | Higher Medicaid % decreases predicted margin | |
| Expense/Bed | 1060078.278 | +0.0736 | Higher Expense/Bed increases predicted margin | |
| Net-to-Gross | 0.887 | +0.0581 | Higher Net-to-Gross increases predicted margin | |
| State Peer Margin | -0.096 | -0.0373 | Lower State Peer Margin decreases predicted margin |
Turnaround: 23%Low turnaround probability (23%). Structural disadvantages in Revenue/Bed and Medicaid %.
Safety-Net/Medicaid Heavy
Archetype
69.5%
Distress Risk
$5.4M
RCM Opportunity
A
Opportunity Grade
-7.4%
Projected Margin
Cluster: Safety-Net/Medicaid Heavy
Percentile within cluster: P94. 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%
MT distress rate: 69.8%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Medicaid Day Pct | 0.755 | +0.666 | ▲ risk |
| Net To Gross Ratio | 0.887 | +0.231 | ▲ risk |
| Revenue Per Bed | 708863.833 | +0.051 | ▲ risk |
| Medicare Day Pct | 0.086 | -0.041 | ▼ risk |
| Occupancy Rate | 0.568 | -0.040 | ▼ risk |
| Beds | 18.000 | -0.017 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $5.4M
Current margin: -49.5%
Projected margin: -7.4%
Grade: A
Comps: 48
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 | 0.158 | 0.451 | 29.3% | $4.4M | 50% | 24mo |
| Occupancy Improvement | 0.568 | 0.717 | 14.9% | $981K | 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 | 33.5 | [25.0, 75.0] | P75 | 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 | 99.3% | [90.0%, 99.5%] | P5 | Strong — predicted net collection rate is in the top third. |