ML Analysis — HOWARD COUNTY MEDICAL CENTER
CCN 281338 | 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.
48
/ 100 (C)
Financial Health3/25
RCM Upside19/25
Market Position14/20
Demand Defensibility5/15
Operational Efficiency8/15
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)
-12.1%
R²=0.34 | n=4,907 | Grade B | Actual: -10.9%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-40.4%, 16.2%]. P33 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 2442701.600 | -0.0968 | Higher Expense/Bed decreases predicted margin | |
| Revenue/Bed | 2202899.900 | +0.0871 | Higher Revenue/Bed increases predicted margin | |
| Log(Beds) | 2.303 | -0.0481 | Lower Log(Beds) decreases predicted margin | |
| Net-to-Gross | 0.736 | +0.0412 | Higher Net-to-Gross increases predicted margin | |
| Reimbursement Quality | 0.283 | -0.0235 | Higher Reimbursement Quality decreases predicted m |
Turnaround: 30%Low turnaround probability (30%). Structural disadvantages in Expense/Bed and Revenue/Bed.
Rural/Critical Access
Archetype
58.4%
Distress Risk
$185K
RCM Opportunity
D
Opportunity Grade
-10.1%
Projected Margin
Cluster: Rural/Critical Access
Percentile within cluster: P7. 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 | 0.247 | +0.259 | ▲ risk |
| Net To Gross Ratio | 0.736 | +0.164 | ▲ risk |
| Medicaid Day Pct | 0.044 | -0.044 | ▼ risk |
| Medicare Day Pct | 0.571 | +0.042 | ▲ risk |
| Revenue Per Bed | 2202899.900 | -0.037 | ▼ risk |
| Beds | 10.000 | -0.019 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $185K
Current margin: -10.9%
Projected margin: -10.1%
Grade: D
Comps: 42
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 | 0.736 | 0.808 | 7.2% | $185K | 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 | 31.3 | [25.0, 75.0] | P66 | 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. |