CEO Decision-making at Prairie Health Services 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 CEO Decision-making at Prairie Health Services case study

At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. CEO Decision-making at Prairie Health Services case study is a Harvard Business School (HBR) case study written by Valerie Wallingford, Sharon Gritzmacher. The CEO Decision-making at Prairie Health Services (referred as “Administrators Prairie” from here on) case study provides evaluation & decision scenario in field of Strategy & Execution. It also touches upon business topics such as - Value proposition, Leadership, Organizational culture, Performance measurement, Strategy.

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 CEO Decision-making at Prairie Health Services Case Study

This case focuses on a significant problem faced by county-owned Prairie Health Service's administrators: What could be done to reduce multiple billings and other redundancies among the four divisions of the organization? The administrators' goal was to implement an integrated records management system that would streamline the registration and billing processes for patients thereby increasing efficiency and timeliness, as well as reducing financial losses. While this was a fiscally responsible goal for the organization, the records management software package selected by the CEO was inadequate for the task. Rather than listen to the recommendations of his division administrators who had spent considerable time researching potential software, the CEO seemed to be basing his selection decision on the personal relationship he had developed with sales representatives from one of the software firms.

Case Authors : Valerie Wallingford, Sharon Gritzmacher

Topic : Strategy & Execution

Related Areas : Leadership, Organizational culture, Performance measurement, Strategy

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Calculating Net Present Value (NPV) at 6% for CEO Decision-making at Prairie Health Services Case Study

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 6 %	Discounted Cash Flows
Year 0	(10027859)	-10027859	-	-
Year 1	3454821	-6573038	3454821	0.9434	3259265
Year 2	3973317	-2599721	7428138	0.89	3536238
Year 3	3953751	1354030	11381889	0.8396	3319646
Year 4	3235917	4589947	14617806	0.7921	2563149
TOTAL			14617806		12678298

The Net Present Value at 6% discount rate is 2650439

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. Net Present Value
3. Profitability Index
4. Internal Rate of Return

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 Administrators Prairie 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. Administrators Prairie 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 CEO Decision-making at Prairie Health Services

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 Strategy & Execution 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 Administrators Prairie 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 Administrators Prairie 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	(10027859)	-10027859	-	-
Year 1	3454821	-6573038	3454821	0.8696	3004192
Year 2	3973317	-2599721	7428138	0.7561	3004398
Year 3	3953751	1354030	11381889	0.6575	2599655
Year 4	3235917	4589947	14617806	0.5718	1850146
TOTAL					10458392

The Net NPV after 4 years is 430533

(10458392 - 10027859 )

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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	(10027859)	-10027859	-	-
Year 1	3454821	-6573038	3454821	0.8333	2879018
Year 2	3973317	-2599721	7428138	0.6944	2759248
Year 3	3953751	1354030	11381889	0.5787	2288050
Year 4	3235917	4589947	14617806	0.4823	1560531
TOTAL					9486847

The Net NPV after 4 years is -541012

At 20% discount rate the NPV is negative (9486847 - 10027859 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Administrators Prairie 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 Administrators Prairie has a NPV value higher than Zero then finance managers at Administrators Prairie 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 Administrators Prairie, then the stock price of the Administrators Prairie 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 Administrators Prairie 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.

Understanding of risks involved in the project.

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

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 CEO Decision-making at Prairie Health Services

References & Further Readings

Valerie Wallingford, Sharon Gritzmacher (2018), "CEO Decision-making at Prairie Health Services Harvard Business Review Case Study. Published by HBR Publications.