Managing Organizational Transformation: Lessons from the Veterans Health Administration 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 Managing Organizational Transformation: Lessons from the Veterans Health Administration case study

At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. Managing Organizational Transformation: Lessons from the Veterans Health Administration case study is a Harvard Business School (HBR) case study written by Gary J. Young. The Managing Organizational Transformation: Lessons from the Veterans Health Administration (referred as “Transformation Veterans” from here on) case study provides evaluation & decision scenario in field of Technology & Operations. It also touches upon business topics such as - Value proposition, Government.

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 Managing Organizational Transformation: Lessons from the Veterans Health Administration Case Study

Managing an organizational transformation is a risky and difficult endeavor. This article examines the lessons learned from the transformation of the Veterans Health Administration (VHA), one of the largest agencies in the federal government. The transformation, which has proven to be highly successful, has focused on changing the agency from a health care delivery system emphasizing inpatient-oriented tertiary care to a health care delivery system that can meet the growing needs of veterans for outpatient-oriented primary care. The VHA's experience reveals the importance of selecting leaders whose qualifications match the needs of the transformation, developing a coherent transformation plan, maintaining a focus on key transformation goals, and managing external changes to complement internal ones. In addition, the VHA's experience reminds us that a transformation often raises significant issues concerning employee training and education, communication with frontline employees, and the balance between centralized control and operating unit flexibility.

Case Authors : Gary J. Young

Topic : Technology & Operations

Related Areas : Government

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Calculating Net Present Value (NPV) at 6% for Managing Organizational Transformation: Lessons from the Veterans Health Administration Case Study

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 6 %	Discounted Cash Flows
Year 0	(10003996)	-10003996	-	-
Year 1	3451860	-6552136	3451860	0.9434	3256472
Year 2	3961476	-2590660	7413336	0.89	3525700
Year 3	3946960	1356300	11360296	0.8396	3313944
Year 4	3228924	4585224	14589220	0.7921	2557610
TOTAL			14589220		12653725

The Net Present Value at 6% discount rate is 2649729

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. Internal Rate of Return
2. Profitability Index
3. Payback Period
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. Transformation Veterans 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 Transformation Veterans 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 Managing Organizational Transformation: Lessons from the Veterans Health Administration

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 Technology & Operations 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 Transformation Veterans 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 Transformation Veterans 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	(10003996)	-10003996	-	-
Year 1	3451860	-6552136	3451860	0.8696	3001617
Year 2	3961476	-2590660	7413336	0.7561	2995445
Year 3	3946960	1356300	11360296	0.6575	2595190
Year 4	3228924	4585224	14589220	0.5718	1846148
TOTAL					10438400

The Net NPV after 4 years is 434404

(10438400 - 10003996 )

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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	(10003996)	-10003996	-	-
Year 1	3451860	-6552136	3451860	0.8333	2876550
Year 2	3961476	-2590660	7413336	0.6944	2751025
Year 3	3946960	1356300	11360296	0.5787	2284120
Year 4	3228924	4585224	14589220	0.4823	1557159
TOTAL					9468854

The Net NPV after 4 years is -535142

At 20% discount rate the NPV is negative (9468854 - 10003996 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Transformation Veterans 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 Transformation Veterans has a NPV value higher than Zero then finance managers at Transformation Veterans 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 Transformation Veterans, then the stock price of the Transformation Veterans 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 Transformation Veterans 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 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.

What can impact the cash flow of the project.

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 Managing Organizational Transformation: Lessons from the Veterans Health Administration

References & Further Readings

Gary J. Young (2018), "Managing Organizational Transformation: Lessons from the Veterans Health Administration Harvard Business Review Case Study. Published by HBR Publications.