American Healthcare REIT

Moat components and scores: Intangible assets 65/100 (regional brand equity at Trilogy, care quality awards, and health‑system relationships); Switching costs 60/100 (resident and family disruption plus referral pathways within ISHC create frictions, though switching is possible); Network effects 35/100 (limited classic network effects, but referral density and campus ecosystems help); Cost advantages 70/100 (scale procurement, in‑house operating platform, and modular campus expansion lower unit costs); Efficient scale 70/100 (localized markets with constrained new supply and entitlement hurdles, especially in higher‑barrier states).

Weighting these toward cost and efficient‑scale drivers yields an aggregate moat in the mid‑60s. The 2024 buyout of the 24% minority in Trilogy consolidated control of the operating platform, strengthening pricing and execution advantages, though this raises exposure to labor and operations versus a landlord‑only model.