Delivering Innovation in Hospital Construction: Contracts and Collaboration in the UK's Private Finance Initiative Hospitals Program Net Present Value (NPV) / MBA Resources

Introduction to Net Present Value (NPV) - What is Net Present Value (NPV) ? How it impacts financial decisions regarding project management?

NPV solution for Delivering Innovation in Hospital Construction: Contracts and Collaboration in the UK's Private Finance Initiative Hospitals Program case study

At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. Delivering Innovation in Hospital Construction: Contracts and Collaboration in the UK's Private Finance Initiative Hospitals Program case study is a Harvard Business School (HBR) case study written by James Barlow, Martina Koberle-Gaiser. The Delivering Innovation in Hospital Construction: Contracts and Collaboration in the UK's Private Finance Initiative Hospitals Program (referred as “Pfi Partly” from here on) case study provides evaluation & decision scenario in field of Organizational Development. It also touches upon business topics such as - Value proposition, Financial management, International business, Project management, Risk management, Strategic planning.

The net present value (NPV) of an investment proposal is the present value of the proposal’s net cash flows less the proposal’s initial cash outflow. If a project’s NPV is greater than or equal to zero, the project should be accepted.

NPV = Present Value of Future Cash Flows LESS Project’s Initial Investment

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Case Description of Delivering Innovation in Hospital Construction: Contracts and Collaboration in the UK's Private Finance Initiative Hospitals Program Case Study

This article discusses the relationship between the system for planning, financing, constructing, and operating new hospitals and the design and construction innovation. It focuses on the UK's Private Finance Initiative (PFI), where consortia of private companies invest in, build, and operate public sector hospital facilities. The PFI was partly introduced to inject increased innovation into the delivery of healthcare infrastructure. Case studies of eight schemes developed over the last decade demonstrate that the PFI model has not generated the anticipated innovation benefits. This is partly due to the way risk is allocated between the project stakeholders and partly to the lack of integration between the hospital trust and the consortium. These represent structural features of PFI that could be improved upon in order to produce better outcomes.

Case Authors : James Barlow, Martina Koberle-Gaiser

Topic : Organizational Development

Related Areas : Financial management, International business, Project management, Risk management, Strategic planning

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Calculating Net Present Value (NPV) at 6% for Delivering Innovation in Hospital Construction: Contracts and Collaboration in the UK's Private Finance Initiative Hospitals Program Case Study

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 6 %	Discounted Cash Flows
Year 0	(10007615)	-10007615	-	-
Year 1	3465629	-6541986	3465629	0.9434	3269461
Year 2	3966327	-2575659	7431956	0.89	3530017
Year 3	3965741	1390082	11397697	0.8396	3329713
Year 4	3223788	4613870	14621485	0.7921	2553542
TOTAL			14621485		12682733

The Net Present Value at 6% discount rate is 2675118

In isolation the NPV number doesn't mean much but put in right context then it is one of the best method to evaluate project returns. In this article we will cover -

Different methods of capital budgeting

What is NPV & Formula of NPV,
How it is calculated,
How to use NPV number for project evaluation, and
Scenario Planning given risks and management priorities.

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Capital Budgeting Approaches

Methods of Capital Budgeting

There are four types of capital budgeting techniques that are widely used in the corporate world –

1. Payback Period
2. Profitability Index
3. Internal Rate of Return
4. Net Present Value

Apart from the Payback period method which is an additive method, rest of the methods are based on Discounted Cash Flow technique. Even though cash flow can be calculated based on the nature of the project, for the simplicity of the article we are assuming that all the expected cash flows are realized at the end of the year.

Discounted Cash Flow approaches provide a more objective basis for evaluating and selecting investment projects. They take into consideration both –

1. Magnitude of both incoming and outgoing cash flows – Projects can be capital intensive, time intensive, or both. Pfi Partly shareholders have preference for diversified projects investment rather than prospective high income from a single capital intensive project.
2. Timing of the expected cash flows – stockholders of Pfi Partly have higher preference for cash returns over 4-5 years rather than 10-15 years given the nature of the volatility in the industry.

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Formula and Steps to Calculate Net Present Value (NPV) of Delivering Innovation in Hospital Construction: Contracts and Collaboration in the UK's Private Finance Initiative Hospitals Program

NPV = Net Cash In Flowt1 / (1+r)t1 + Net Cash In Flowt2 / (1+r)t2 + … Net Cash In Flowtn / (1+r)tn
Less Net Cash Out Flowt0 / (1+r)t0

Where t = time period, in this case year 1, year 2 and so on.
r = discount rate or return that could be earned using other safe proposition such as fixed deposit or treasury bond rate. Net Cash In Flow – What the firm will get each year.
Net Cash Out Flow – What the firm needs to invest initially in the project.

Step 1 – Understand the nature of the project and calculate cash flow for each year.
Step 2 – Discount those cash flow based on the discount rate.
Step 3 – Add all the discounted cash flow.
Step 4 – Selection of the project

Why Organizational Development Managers need to know Financial Tools such as Net Present Value (NPV)?

In our daily workplace we often come across people and colleagues who are just focused on their core competency and targets they have to deliver. For example marketing managers at Pfi Partly often design programs whose objective is to drive brand awareness and customer reach. But how that 30 point increase in brand awareness or 10 point increase in customer touch points will result into shareholders’ value is not specified.

To overcome such scenarios managers at Pfi Partly needs to not only know the financial aspect of project management but also needs to have tools to integrate them into part of the project development and monitoring plan.

Calculating Net Present Value (NPV) at 15%

After working through various assumptions we reached a conclusion that risk is far higher than 6%. In a reasonably stable industry with weak competition - 15% discount rate can be a good benchmark.

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 15 %	Discounted Cash Flows
Year 0	(10007615)	-10007615	-	-
Year 1	3465629	-6541986	3465629	0.8696	3013590
Year 2	3966327	-2575659	7431956	0.7561	2999113
Year 3	3965741	1390082	11397697	0.6575	2607539
Year 4	3223788	4613870	14621485	0.5718	1843211
TOTAL					10463454

The Net NPV after 4 years is 455839

(10463454 - 10007615 )

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Calculating Net Present Value (NPV) at 20%

If the risk component is high in the industry then we should go for a higher hurdle rate / discount rate of 20%.

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 20 %	Discounted Cash Flows
Year 0	(10007615)	-10007615	-	-
Year 1	3465629	-6541986	3465629	0.8333	2888024
Year 2	3966327	-2575659	7431956	0.6944	2754394
Year 3	3965741	1390082	11397697	0.5787	2294989
Year 4	3223788	4613870	14621485	0.4823	1554682
TOTAL					9492089

The Net NPV after 4 years is -515526

At 20% discount rate the NPV is negative (9492089 - 10007615 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Pfi Partly to discount cash flow at lower discount rates such as 15%.

Acceptance Criteria of a Project based on NPV

Simplest Approach – If the investment project of Pfi Partly has a NPV value higher than Zero then finance managers at Pfi Partly can ACCEPT the project, otherwise they can reject the project. This means that project will deliver higher returns over the period of time than any alternate investment strategy.

In theory if the required rate of return or discount rate is chosen correctly by finance managers at Pfi Partly, then the stock price of the Pfi Partly should change by same amount of the NPV. In real world we know that share price also reflects various other factors that can be related to both macro and micro environment.

In the same vein – accepting the project with zero NPV should result in stagnant share price. Finance managers use discount rates as a measure of risk components in the project execution process.

Sensitivity Analysis

Project selection is often a far more complex decision than just choosing it based on the NPV number. Finance managers at Pfi Partly should conduct a sensitivity analysis to better understand not only the inherent risk of the projects but also how those risks can be either factored in or mitigated during the project execution. Sensitivity analysis helps in –

What are the key aspects of the projects that need to be monitored, refined, and retuned for continuous delivery of projected cash flows.

What can impact the cash flow of the project.

What are the uncertainties surrounding the project Initial Cash Outlay (ICO’s). ICO’s often have several different components such as land, machinery, building, and other equipment.

What will be a multi year spillover effect of various taxation regulations.

Understanding of risks involved in the project.

Some of the assumptions while using the Discounted Cash Flow Methods –

Projects are assumed to be Mutually Exclusive – This is seldom the came in modern day giant organizations where projects are often inter-related and rejecting a project solely based on NPV can result in sunk cost from a related project.

Independent projects have independent cash flows – As explained in the marketing project – though the project may look independent but in reality it is not as the brand awareness project can be closely associated with the spending on sales promotions and product specific advertising.

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Negotiation Strategy of Delivering Innovation in Hospital Construction: Contracts and Collaboration in the UK's Private Finance Initiative Hospitals Program

References & Further Readings

James Barlow, Martina Koberle-Gaiser (2018), "Delivering Innovation in Hospital Construction: Contracts and Collaboration in the UK's Private Finance Initiative Hospitals Program Harvard Business Review Case Study. Published by HBR Publications.