President and the Power of the Purchaser: Consumer Protection and Managed Care in the United States 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 President and the Power of the Purchaser: Consumer Protection and Managed Care in the United States case study

At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. President and the Power of the Purchaser: Consumer Protection and Managed Care in the United States case study is a Harvard Business School (HBR) case study written by Daniel P. Gitterman. The President and the Power of the Purchaser: Consumer Protection and Managed Care in the United States (referred as “Purchaser Federal” from here on) case study provides evaluation & decision scenario in field of Technology & Operations. It also touches upon business topics such as - Value proposition, Health, Personnel policies.

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

---

Case Description of President and the Power of the Purchaser: Consumer Protection and Managed Care in the United States Case Study

This article highlights the President's formal and informal capacity to act unilaterally, and thus potentially to regulate managed care on his own, through the government's role as a buyer--what is referred to here as the "power of the purchaser." Presidents can act independently to shift policy in any way they wish, and there it will stay until and unless either Congress, the courts, or the market effectively responds. By the strategic use of executive orders and directives to the federal bureaucracy, President Clinton used the "power of the purchaser" to implement a range of consumer protections as a condition in any contract between federal "public" purchasers and health plans. In practice, those health plans and insurers wishing to do business with the federal government must meet the President's terms; others either need not enter into a contract or exit ex-post when they oppose the nature of the new provisions.

Case Authors : Daniel P. Gitterman

Topic : Technology & Operations

Related Areas : Health, Personnel policies

---

Calculating Net Present Value (NPV) at 6% for President and the Power of the Purchaser: Consumer Protection and Managed Care in the United States Case Study

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 6 %	Discounted Cash Flows
Year 0	(10001472)	-10001472	-	-
Year 1	3460603	-6540869	3460603	0.9434	3264720
Year 2	3971930	-2568939	7432533	0.89	3535004
Year 3	3954790	1385851	11387323	0.8396	3320518
Year 4	3248693	4634544	14636016	0.7921	2573269
TOTAL			14636016		12693510

The Net Present Value at 6% discount rate is 2692038

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.

---

Capital Budgeting Approaches

Methods of Capital Budgeting

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

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

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 Purchaser Federal 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. Purchaser Federal shareholders have preference for diversified projects investment rather than prospective high income from a single capital intensive project.

---

Formula and Steps to Calculate Net Present Value (NPV) of President and the Power of the Purchaser: Consumer Protection and Managed Care in the United States

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 Purchaser Federal 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 Purchaser Federal 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	(10001472)	-10001472	-	-
Year 1	3460603	-6540869	3460603	0.8696	3009220
Year 2	3971930	-2568939	7432533	0.7561	3003350
Year 3	3954790	1385851	11387323	0.6575	2600339
Year 4	3248693	4634544	14636016	0.5718	1857451
TOTAL					10470359

The Net NPV after 4 years is 468887

(10470359 - 10001472 )

---

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	(10001472)	-10001472	-	-
Year 1	3460603	-6540869	3460603	0.8333	2883836
Year 2	3971930	-2568939	7432533	0.6944	2758285
Year 3	3954790	1385851	11387323	0.5787	2288652
Year 4	3248693	4634544	14636016	0.4823	1566692
TOTAL					9497464

The Net NPV after 4 years is -504008

At 20% discount rate the NPV is negative (9497464 - 10001472 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Purchaser Federal 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 Purchaser Federal has a NPV value higher than Zero then finance managers at Purchaser Federal 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 Purchaser Federal, then the stock price of the Purchaser Federal 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 Purchaser Federal 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 can impact the cash flow of the project.

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.

---

Negotiation Strategy of President and the Power of the Purchaser: Consumer Protection and Managed Care in the United States

References & Further Readings

Daniel P. Gitterman (2018), "President and the Power of the Purchaser: Consumer Protection and Managed Care in the United States Harvard Business Review Case Study. Published by HBR Publications.