ML Analysis — AVERA ST. ANTHONYS HOSPITAL
CCN 281329 | 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.
45
/ 100 (C)
Financial Health9/25
RCM Upside13/25
Market Position13/20
Demand Defensibility3/15
Operational Efficiency7/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Heavy Medicare dependence (>55%)
- Small facility (<50 beds) — limited scale
Catalysts:
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-5.3%
R²=0.34 | n=4,907 | Grade B | Actual: 4.9%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-33.6%, 23.0%]. P48 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Log(Beds) | 3.219 | -0.0268 | Lower Log(Beds) decreases predicted margin | |
| Bed Count | 25.000 | +0.0193 | Higher Bed Count increases predicted margin | |
| Revenue/Bed | 1712161.240 | +0.0185 | Higher Revenue/Bed increases predicted margin | |
| Net-to-Gross | 0.489 | +0.0134 | Higher Net-to-Gross increases predicted margin | |
| State Peer Margin | -0.063 | -0.0129 | Lower State Peer Margin decreases predicted margin |
Rural/Critical Access
Archetype
53.7%
Distress Risk
$2.7M
RCM Opportunity
C
Opportunity Grade
11.1%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P29. 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%
NE distress rate: 53.1%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.339 | +0.173 | ▲ risk |
| Medicaid Day Pct | 0.004 | -0.085 | ▼ risk |
| Medicare Day Pct | 0.672 | +0.059 | ▲ risk |
| Net To Gross Ratio | 0.489 | +0.053 | ▲ risk |
| Beds | 25.000 | -0.017 | ▼ risk |
| Revenue Per Bed | 1712161.240 | -0.008 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $2.7M
Current margin: 4.9%
Projected margin: 11.1%
Grade: C
Comps: 65
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 | 0.489 | 0.779 | 29.0% | $1.5M | 65% | 18mo |
| Payer Mix Optimization | 0.324 | 0.405 | 8.1% | $1.2M | 50% | 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 | 29.8 | [25.0, 75.0] | P57 | 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. |