ML Analysis — BOONE COUNTY HEALTH CENTER
CCN 281334 | 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.
41
/ 100 (D)
Financial Health5/25
RCM Upside16/25
Market Position11/20
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
Catalysts:
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-5.9%
R²=0.34 | n=4,907 | Grade B | Actual: -0.2%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-34.2%, 22.4%]. P47 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Net-to-Gross | 0.713 | +0.0386 | Higher Net-to-Gross increases predicted margin | |
| Log(Beds) | 3.219 | -0.0268 | Lower Log(Beds) decreases predicted margin | |
| Expense/Bed | 1483358.920 | +0.0214 | Higher Expense/Bed increases predicted margin | |
| Bed Count | 25.000 | +0.0193 | Higher Bed Count increases predicted margin | |
| Bed Utilization Value | 379626.381 | -0.0164 | Lower Bed Utilization Value decreases predicted ma |
Turnaround: 40%Turnaround possible (40%) but uncertain. Margin improvement depends on Net-to-Gross.
Rural/Critical Access
Archetype
59.6%
Distress Risk
$3.2M
RCM Opportunity
C
Opportunity Grade
8.3%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P21. 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 | 0.257 | +0.249 | ▲ risk |
| Net To Gross Ratio | 0.713 | +0.153 | ▲ risk |
| Medicare Day Pct | 0.745 | +0.072 | ▲ risk |
| Medicaid Day Pct | 0.043 | -0.046 | ▼ risk |
| Beds | 25.000 | -0.017 | ▼ risk |
| Revenue Per Bed | 1479748.280 | +0.006 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $3.2M
Current margin: -0.2%
Projected margin: 8.3%
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 |
|---|---|---|---|---|---|---|
| Payer Mix Optimization | 0.213 | 0.405 | 19.2% | $2.9M | 50% | 24mo |
| Net-to-Gross Ratio Improvement | 0.713 | 0.779 | 6.6% | $286K | 65% | 18mo |
| Occupancy Improvement | 0.257 | 0.257 | 0.1% | $4K | 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 | 29.3 | [25.0, 75.0] | P52 | 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. |