The Affordable Care Act (A): Legislative Strategy in the House of Representatives 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 The Affordable Care Act (A): Legislative Strategy in the House of Representatives case study

At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. The Affordable Care Act (A): Legislative Strategy in the House of Representatives case study is a Harvard Business School (HBR) case study written by Joseph L. Bower, Michael Norris. The The Affordable Care Act (A): Legislative Strategy in the House of Representatives (referred as “Legislative Representatives” from here on) case study provides evaluation & decision scenario in field of Organizational Development. It also touches upon business topics such as - Value proposition, Health.

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 The Affordable Care Act (A): Legislative Strategy in the House of Representatives Case Study

In early 2009, the Obama administration and the Democratically-led Congress began working on what would eventually become the Affordable Care Act. The (A) case in this series discusses the legislative strategy in the House of Representatives, where three different committees each had jurisdiction over health care legislation.

Case Authors : Joseph L. Bower, Michael Norris

Topic : Organizational Development

Related Areas : Health

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Calculating Net Present Value (NPV) at 6% for The Affordable Care Act (A): Legislative Strategy in the House of Representatives Case Study

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 6 %	Discounted Cash Flows
Year 0	(10010631)	-10010631	-	-
Year 1	3470014	-6540617	3470014	0.9434	3273598
Year 2	3971157	-2569460	7441171	0.89	3534316
Year 3	3957052	1387592	11398223	0.8396	3322417
Year 4	3251685	4639277	14649908	0.7921	2575639
TOTAL			14649908		12705970

The Net Present Value at 6% discount rate is 2695339

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

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Formula and Steps to Calculate Net Present Value (NPV) of The Affordable Care Act (A): Legislative Strategy in the House of Representatives

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 Legislative Representatives 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 Legislative Representatives 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	(10010631)	-10010631	-	-
Year 1	3470014	-6540617	3470014	0.8696	3017403
Year 2	3971157	-2569460	7441171	0.7561	3002765
Year 3	3957052	1387592	11398223	0.6575	2601826
Year 4	3251685	4639277	14649908	0.5718	1859161
TOTAL					10481156

The Net NPV after 4 years is 470525

(10481156 - 10010631 )

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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	(10010631)	-10010631	-	-
Year 1	3470014	-6540617	3470014	0.8333	2891678
Year 2	3971157	-2569460	7441171	0.6944	2757748
Year 3	3957052	1387592	11398223	0.5787	2289961
Year 4	3251685	4639277	14649908	0.4823	1568135
TOTAL					9507522

The Net NPV after 4 years is -503109

At 20% discount rate the NPV is negative (9507522 - 10010631 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Legislative Representatives 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 Legislative Representatives has a NPV value higher than Zero then finance managers at Legislative Representatives 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 Legislative Representatives, then the stock price of the Legislative Representatives 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 Legislative Representatives 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 –

Understanding of risks involved in the project.

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

What can impact the cash flow of the project.

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

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.

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 The Affordable Care Act (A): Legislative Strategy in the House of Representatives

References & Further Readings

Joseph L. Bower, Michael Norris (2018), "The Affordable Care Act (A): Legislative Strategy in the House of Representatives Harvard Business Review Case Study. Published by HBR Publications.