The Integrated Vulnerability Measure A Novel Financial Distress Index for U.S. Hospitals
Clicks: 1
ID: 317186
2026
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This
article has not been analysed, so there is no overall score —
reader engagement is measured and shown alongside.
Reader Engagement
0.0
/100
1 views
0 readers
AI Quality Assessment
Not analyzed
Readership in this journal
Ranked #80 of 93 articles by views in Health Affairs Scholar
Most read
Least read
Bar heights use a square-root scale.
Mint this article as an NFT
Not yet mintedCreate a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.
5
SUSD
one-off · no wallet required
Abstract
Abstract Introduction Hospital closures and other manifestations of financial distress threaten timely access to care across the United States. Widely used, publicly available distress indicators have important limitations when they are applied to the full spectrum of hospital types and operating environments. Methods Using Medicare cost report data from the Healthcare Cost Report Information System (HCRIS) from 2017 to 2022, the Integrated Vulnerability Measure (IVM) was developed as a composite index that forecasts whether an acute-care or Critical Access Hospital (CAH) will enter financial distress in two years. Financial distress was defined as closure, cash flow margin below -5 percent, or negative equity two years after the observation year. Hospitals were also grouped into four risk categories based on predicted probability. Results The Integrated Vulnerability Measure showed strong predictive power and sorted hospitals into meaningful risk groups. In the validation sample, 51 percent of hospitals were classified as low risk, 30 percent as mid-low risk, 11 percent as mid-high risk, and 8 percent as high risk. Hospitals in higher-risk groups were substantially more likely to experience financial distress within two years than those in lower-risk groups. Conclusions By offering a flexible and generalizable measure, the IVM gives policymakers, regulators, and health system leaders a tool for early identification of vulnerable hospitals and for targeting technical assistance or other interventions that help preserve local access to essential care.
| Reference Key |
openalex_W7164589540
Use this key to autocite in the manuscript while using
SciMatic Manuscript Manager or Thesis Manager
|
|---|---|
| Authors | Julianna Bernardi, Paul Ursino, Kevin Gormley, Colleen Rye, Matt Boyas, Sam Steckley |
| Journal | Health Affairs Scholar |
| Year | 2026 |
| DOI |
10.1093/haschl/qxag135
|
| URL | |
| Keywords | Keywords not found |
Citations
No citations found. To add a citation, contact the admin at info@scimatic.org
Comments
No comments yet. Be the first to comment on this article.