Shared Decision Making 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 Shared Decision Making case study

At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. Shared Decision Making case study is a Harvard Business School (HBR) case study written by Richard Bohmer, Laura R. Feldman, Karen Sepucha. The Shared Decision Making (referred as “Sdps Foundation” from here on) case study provides evaluation & decision scenario in field of Technology & Operations. It also touches upon business topics such as - Value proposition, Entrepreneurship, Innovation, IT, Strategy execution.

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 Shared Decision Making Case Study

The Foundation for Informed Medical Decision-Making has created an interactive videodisc system that provides patients with customized support regarding medical treatment or screening decisions when they face a choice between two equally effective courses of action. The videodiscs, known as shared decision-making programs (SDPs), were the result of considering grant-funded research into treatment outcomes and patients' preferences concerning varying medical treatments. Over a six-year period, the foundation has partnered with a variety of commercial firms to manufacture and market the SDPs. Despite robust evidence supporting the effectiveness of the SDPs and the enthusiastic response of early purchasers, the foundation has been unable to widely disseminate the product and faces major debt.

Case Authors : Richard Bohmer, Laura R. Feldman, Karen Sepucha

Topic : Technology & Operations

Related Areas : Entrepreneurship, Innovation, IT, Strategy execution

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Calculating Net Present Value (NPV) at 6% for Shared Decision Making Case Study

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 6 %	Discounted Cash Flows
Year 0	(10021961)	-10021961	-	-
Year 1	3462660	-6559301	3462660	0.9434	3266660
Year 2	3960708	-2598593	7423368	0.89	3525016
Year 3	3959001	1360408	11382369	0.8396	3324054
Year 4	3228062	4588470	14610431	0.7921	2556927
TOTAL			14610431		12672657

The Net Present Value at 6% discount rate is 2650696

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. Internal Rate of Return
4. Profitability Index

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 Sdps Foundation 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. Sdps Foundation 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 Shared Decision Making

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 Sdps Foundation 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 Sdps Foundation 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	(10021961)	-10021961	-	-
Year 1	3462660	-6559301	3462660	0.8696	3011009
Year 2	3960708	-2598593	7423368	0.7561	2994864
Year 3	3959001	1360408	11382369	0.6575	2603107
Year 4	3228062	4588470	14610431	0.5718	1845655
TOTAL					10454635

The Net NPV after 4 years is 432674

(10454635 - 10021961 )

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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	(10021961)	-10021961	-	-
Year 1	3462660	-6559301	3462660	0.8333	2885550
Year 2	3960708	-2598593	7423368	0.6944	2750492
Year 3	3959001	1360408	11382369	0.5787	2291089
Year 4	3228062	4588470	14610431	0.4823	1556743
TOTAL					9483873

The Net NPV after 4 years is -538088

At 20% discount rate the NPV is negative (9483873 - 10021961 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Sdps Foundation 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 Sdps Foundation has a NPV value higher than Zero then finance managers at Sdps Foundation 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 Sdps Foundation, then the stock price of the Sdps Foundation 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 Sdps Foundation 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 will be a multi year spillover effect of various taxation regulations.

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.

Understanding of risks involved in 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.

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 Shared Decision Making

References & Further Readings

Richard Bohmer, Laura R. Feldman, Karen Sepucha (2018), "Shared Decision Making Harvard Business Review Case Study. Published by HBR Publications.