Evidence map›Paper›PMID 42761535›Full record

ArticleHealth affairs scholar2026

The integrated vulnerability measure a novel financial distress index for US hospitals.

Julianna Bernardi, Paul Ursino, Kevin Gormley, Colleen Rye, Matt Boyas, Sam Steckley

Abstract read
In one paragraph

Article in Health affairs scholar, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Julianna BernardiThe MITRE Corporation, Bedford, MA 01730, United States.
Paul UrsinoPwC, Boston, MA 02210, United States.
Kevin GormleyECS, Fairfax, VA 22031, United States.ORCID https://orcid.org/0009-0004-5889-4622
Colleen RyeRye & Associates, Atlanta, GA, United States.
Matt BoyasLinksbridge SPC, Seattle, WA 98109, United States.ORCID https://orcid.org/0009-0002-7880-4335
Sam SteckleyThe MITRE Corporation, Bedford, MA 01730, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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 applied across diverse hospital types and operating environments. Results: The IVM showed strong predictive power and sorted hospitals into meaningful risk groups. In the validation sample, 51% of hospitals were classified as low risk, 30% as mid-low risk, 11% as mid-high risk, and 8% as high risk. Higher-risk hospitals were substantially more likely than lower-risk hospitals to experience financial distress within two years. Conclusion: The IVM provides a flexible, generalizable tool for early identification of vulnerable hospitals and for targeting technical assistance, oversight, or interventions to preserve local access to essential care.

Indexed as

financial riskHealthcare Cost Report Information Systemhealth economicshospital closureshospital financial distress

Identifiers

PMID42761535
PMCPMC13587824

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.