ML Analysis — MOUNT SINAI HEALTH SYSTEM-BETH ISRAE
CCN 330169 | 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.
55
/ 100 (C)
Financial Health9/25
RCM Upside20/25
Market Position9/20
Demand Defensibility15/15
Operational Efficiency2/15
Entry Multiple: 8.0x – 10.0x
Est. MOIC: 1.9x
Risk Factors:
- Negative operating margin
- Expenses exceed revenue
Catalysts:
- RCM optimization could add 3-5pp margin
- Strong commercial payer base protects revenue
Margin Prediction (Trained Ridge Model)
-18.9%
R²=0.34 | n=4,907 | Grade B | Actual: -33.7%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-47.2%, 9.4%]. P22 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Expense/Bed | 2452814.119 | -0.0980 | Higher Expense/Bed decreases predicted margin | |
| State Peer Margin | -0.175 | -0.0960 | Lower State Peer Margin decreases predicted margin | |
| Bed Count | 437.000 | -0.0450 | Higher Bed Count decreases predicted margin | |
| Log(Beds) | 6.080 | +0.0396 | Higher Log(Beds) increases predicted margin | |
| Revenue/Bed | 1834716.799 | +0.0357 | Higher Revenue/Bed increases predicted margin |
Turnaround: 21%Low turnaround probability (21%). Structural disadvantages in Expense/Bed and State Peer Margin.
Suburban Community Hospit
Archetype
41.8%
Distress Risk
$22.3M
RCM Opportunity
D
Opportunity Grade
-30.9%
Projected Margin
Cluster: Suburban Community Hospital
Percentile within cluster: P90. Community hospitals — the largest PE deal category. Focus on RCM improvement and cost optimization at 9-11x.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| CLARA MAASS MEDICAL CENTER | NJ | 259 |
| PRESENCE SAINTS MARY & ELIZABETH MED | IL | 266 |
| ADVENTIST HEALTH BAKERSFIELD | CA | 254 |
| BRISTOL REGIONAL MEDICAL CENTER | TN | 244 |
| HOLSTON VALLEY HOSP & MED CTR | TN | 286 |
| SPRINGFIELD REGIONAL MEDICAL CENTER | OH | 230 |
Distress Analysis
Risk: Elevated
National distress rate: 49.3%
NY distress rate: 84.9%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Occupancy Rate | 0.776 | -0.232 | ▼ risk |
| Net To Gross Ratio | 0.208 | -0.071 | ▼ risk |
| Beds | 437.000 | +0.039 | ▲ risk |
| Medicaid Day Pct | 0.070 | -0.019 | ▼ risk |
| Revenue Per Bed | 1834716.799 | -0.015 | ▼ risk |
| Medicare Day Pct | 0.303 | -0.004 | ▼ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $22.3M
Current margin: -33.7%
Projected margin: -30.9%
Grade: D
Comps: 64
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 | 0.208 | 0.419 | 21.1% | $19.8M | 65% | 18mo |
| Payer Mix Optimization | 0.626 | 0.746 | 11.9% | $1.8M | 50% | 24mo |
| Occupancy Improvement | 0.776 | 0.886 | 11.1% | $731K | 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 | 25.0 | [25.0, 75.0] | P0 | 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. |