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Be Well Hospitals - Branding a Mid-Tier Service in a Two-Tier Market 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 Be Well Hospitals - Branding a Mid-Tier Service in a Two-Tier Market case study


At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. Be Well Hospitals - Branding a Mid-Tier Service in a Two-Tier Market case study is a Harvard Business School (HBR) case study written by Piyush Kumar, Sonia Mehrotra, Geetika Shah. The Be Well Hospitals - Branding a Mid-Tier Service in a Two-Tier Market (referred as “Hospitals Tier” from here on) case study provides evaluation & decision scenario in field of Strategy & Execution. It also touches upon business topics such as - Value proposition, Supply chain.

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 Be Well Hospitals - Branding a Mid-Tier Service in a Two-Tier Market Case Study


Be Well Hospitals - a multi-specialty secondary healthcare chain of hospitals is set up in the suburbs, industrial towns and district headquarters of the South Indian state of Tamil Nadu. The hospital chain co-founded by Dr. C.J.Vetrievel in 2011, fulfills the need of quality healthcare services in secondary healthcare market segment. They provide access to high-quality primary and secondary healthcare services at affordable price to the semi-urban and rural population through their chain of multi-specialty hospitals. In the four and half years, since its founding, Be Well has set up eight hospitals with a combined capacity of more than 280 beds and has treated close to 500,000 patients. The case describes Be Well's operations and the marketing initiatives it deployed to increase the adoption of its service concept in a two -tiered market. it provides information about the content of Be Well's past advertising communications and the media choices it made to build its brand. The management is grappling with the dilemma of brand building and educating potential customers about the high quality of care available at Be Well in a format that had a smaller footprint than its big city rivals. A complicating factor is creating a three-tier market with the limited resources in a setting where the customers are used to a two-tier service structure. They face a resource allocation challenge with regard to the mix of media-based and non-media based communication platforms. The management needs to decided on the choice of service attributes or dimensions around which the Be Well brand to be built and whether to focus on local branding of each hospital or develop a unified and common brand across all its facilities in the state.


Case Authors : Piyush Kumar, Sonia Mehrotra, Geetika Shah

Topic : Strategy & Execution

Related Areas : Supply chain




Calculating Net Present Value (NPV) at 6% for Be Well Hospitals - Branding a Mid-Tier Service in a Two-Tier Market Case Study


Years              Cash Flow     Net Cash Flow     Cumulative    
Cash Flow
Discount Rate
@ 6 %
Discounted
Cash Flows
Year 0 (10017615) -10017615 - -
Year 1 3455859 -6561756 3455859 0.9434 3260244
Year 2 3965831 -2595925 7421690 0.89 3529575
Year 3 3943293 1347368 11364983 0.8396 3310865
Year 4 3247005 4594373 14611988 0.7921 2571932
TOTAL 14611988 12672617




The Net Present Value at 6% discount rate is 2655002

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. 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 Hospitals Tier 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. Hospitals Tier 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 Be Well Hospitals - Branding a Mid-Tier Service in a Two-Tier Market

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 Hospitals Tier 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 Hospitals Tier 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 (10017615) -10017615 - -
Year 1 3455859 -6561756 3455859 0.8696 3005095
Year 2 3965831 -2595925 7421690 0.7561 2998738
Year 3 3943293 1347368 11364983 0.6575 2592779
Year 4 3247005 4594373 14611988 0.5718 1856486
TOTAL 10453098


The Net NPV after 4 years is 435483

(10453098 - 10017615 )








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 (10017615) -10017615 - -
Year 1 3455859 -6561756 3455859 0.8333 2879883
Year 2 3965831 -2595925 7421690 0.6944 2754049
Year 3 3943293 1347368 11364983 0.5787 2281998
Year 4 3247005 4594373 14611988 0.4823 1565878
TOTAL 9481808


The Net NPV after 4 years is -535807

At 20% discount rate the NPV is negative (9481808 - 10017615 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Hospitals Tier 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 Hospitals Tier has a NPV value higher than Zero then finance managers at Hospitals Tier 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 Hospitals Tier, then the stock price of the Hospitals Tier 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 Hospitals Tier 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 are the key aspects of the projects that need to be monitored, refined, and retuned for continuous delivery of projected cash flows.

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.

What can impact the cash flow of 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 Be Well Hospitals - Branding a Mid-Tier Service in a Two-Tier Market

References & Further Readings

Piyush Kumar, Sonia Mehrotra, Geetika Shah (2018), "Be Well Hospitals - Branding a Mid-Tier Service in a Two-Tier Market Harvard Business Review Case Study. Published by HBR Publications.


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