ML Analysis — BIG SKY MEDICAL CENTER
CCN 271389 | 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.
46
/ 100 (C)
Financial Health4/25
RCM Upside18/25
Market Position15/20
Demand Defensibility3/15
Operational Efficiency6/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Heavy Medicare dependence (>55%)
- Small facility (<50 beds) — limited scale
- Low occupancy (<30%) — demand risk
- Expenses exceed revenue
Catalysts:
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-23.6%
R²=0.34 | n=4,907 | Grade B | Actual: -28.5%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-51.9%, 4.7%]. P17 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 2382494.875 | -0.0893 | Higher Expense/Bed decreases predicted margin | |
| Log(Beds) | 2.079 | -0.0533 | Lower Log(Beds) decreases predicted margin | |
| Net-to-Gross | 0.711 | +0.0384 | Higher Net-to-Gross increases predicted margin | |
| Revenue/Bed | 1853892.625 | +0.0383 | Higher Revenue/Bed increases predicted margin | |
| State Peer Margin | -0.096 | -0.0373 | Lower State Peer Margin decreases predicted margin |
Turnaround: 16%Low turnaround probability (16%). Structural disadvantages in Expense/Bed and Log(Beds).
Rural/Critical Access
Archetype
62.3%
Distress Risk
$4.9M
RCM Opportunity
A
Opportunity Grade
4.6%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P74. 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 |
|---|---|---|---|
| Occupancy Rate | 0.040 | +0.450 | ▲ risk |
| Net To Gross Ratio | 0.711 | +0.153 | ▲ risk |
| Medicaid Day Pct | 0.009 | -0.080 | ▼ risk |
| Medicare Day Pct | 0.556 | +0.039 | ▲ risk |
| Beds | 8.000 | -0.019 | ▼ risk |
| Revenue Per Bed | 1853892.625 | -0.016 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $4.9M
Current margin: -28.5%
Projected margin: 4.6%
Grade: A
Comps: 383
Gap analysis vs P75 peers with 60% closure assumption. Confidence-weighted by lever implementation difficulty.
| Lever | Current | Benchmark | Gap | Impact | Confidence | Timeline |
|---|---|---|---|---|---|---|
| Occupancy Improvement | 0.040 | 0.423 | 38.3% | $2.5M | 55% | 24mo |
| Payer Mix Optimization | 0.436 | 0.593 | 15.7% | $2.4M | 50% | 24mo |
| Net-to-Gross Ratio Improvement | 0.711 | 0.728 | 1.7% | $29K | 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 | 34.6 | [25.0, 75.0] | P78 | 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. |