ML Analysis — HOSPITAL DR. ALEJANDRO OTERO
CCN 400114 | 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 Health8/25
RCM Upside17/25
Market Position15/20
Demand Defensibility11/15
Operational Efficiency4/15
Entry Multiple: 9.5x – 11.5x
Est. MOIC: 2.3x
Risk Factors:
- Negative operating margin
Catalysts:
- RCM optimization could add 3-5pp margin
- Strong commercial payer base protects revenue
- Limited competition supports pricing power
Margin Prediction (Trained Ridge Model)
-12.7%
R²=0.34 | n=4,907 | Grade B | Actual: -1.0%
Ridge regression trained on 4,907 HCRIS hospitals. 90% CI: [-41.0%, 15.6%]. P32 nationally.
| Driver | Value | Effect | Explanation | |
|---|---|---|---|---|
| Revenue/Bed | 490619.517 | -0.1520 | Lower Revenue/Bed decreases predicted margin | |
| Expense/Bed | 495708.251 | +0.1431 | Higher Expense/Bed increases predicted margin | |
| Reimbursement Quality | 0.316 | -0.0330 | Higher Reimbursement Quality decreases predicted m | |
| Medicaid % | 0.348 | -0.0313 | Higher Medicaid % decreases predicted margin | |
| State Peer Margin | -0.088 | -0.0313 | Lower State Peer Margin decreases predicted margin |
Turnaround: 29%Low turnaround probability (29%). Structural disadvantages in Revenue/Bed and Expense/Bed.
Safety-Net/Medicaid Heavy
Archetype
53.4%
Distress Risk
$5.6M
RCM Opportunity
D
Opportunity Grade
3.3%
Projected Margin
Cluster: Safety-Net/Medicaid Heavy
Percentile within cluster: P16. High Medicaid dependence creates reimbursement risk. Assess DSH payments and state expansion status.
Nearest Peers
| Hospital | State | Beds |
|---|---|---|
| WESTERN PEAKS SPECIALTY HOSPITAL | UT | 59 |
| HOSPITAL MENONITA AIBONITO | PR | 129 |
| TOPPENISH COMMUNITY HOSPITAL | WA | 47 |
| MINERAL COMMUNITY HOSPITAL | MT | 25 |
| BANNER UNIVERSITY MED CENTER SOUTH | AZ | 132 |
| NORTH COLORADO MEDICAL CENTER | CO | 202 |
Distress Analysis
Risk: High
National distress rate: 49.3%
PR distress rate: 55.2%
Model AUC: 0.629
| Factor | Value | Contribution | Direction |
|---|---|---|---|
| Medicaid Day Pct | 0.348 | +0.259 | ▲ risk |
| Occupancy Rate | 0.747 | -0.206 | ▼ risk |
| Net To Gross Ratio | 0.539 | +0.076 | ▲ risk |
| Revenue Per Bed | 490619.517 | +0.064 | ▲ risk |
| Medicare Day Pct | 0.066 | -0.045 | ▼ risk |
| Beds | 263.000 | +0.015 | ▲ risk |
RCM Improvement Opportunity
Total (risk-adjusted): $5.6M
Current margin: -1.0%
Projected margin: 3.3%
Grade: D
Comps: 27
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 | 0.539 | 0.765 | 22.5% | $3.4M | 65% | 18mo |
| Payer Mix Optimization | 0.586 | 0.732 | 14.6% | $2.2M | 50% | 24mo |
| Occupancy Improvement | 0.747 | 0.750 | 0.3% | $17K | 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. |