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GE Healthcare in India: An (Ultra)Sound Strategy? 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 GE Healthcare in India: An (Ultra)Sound Strategy? case study


At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. GE Healthcare in India: An (Ultra)Sound Strategy? case study is a Harvard Business School (HBR) case study written by Jared Harris, Mayank Jain, Jenny Mead. The GE Healthcare in India: An (Ultra)Sound Strategy? (referred as “Ultrasound Prenatal” from here on) case study provides evaluation & decision scenario in field of Global Business. It also touches upon business topics such as - Value proposition, Cross-cultural management, Ethics, Social responsibility.

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 GE Healthcare in India: An (Ultra)Sound Strategy? Case Study


This case outlines the dilemma of V. Raja, president and CEO of GE Healthcare India, when the company's ultrasound machines were implicated in many cases of prenatal sex determination. Even in the 21st century, Indian society favored males and many in India saw females as a burden on their families. Studies had shown that fewer and fewer girls were being born, with potentially catastrophic results for future Indian society. The reason: Many women were relying on ultrasound machines to determine the gender of their fetus and, if it were a girl, having abortions. Raja knew that GE Healthcare and ultrasound machines were providing much better medical care for Indians, particularly those in rural communities, and that the company was following all the rules and regulations to prevent this type of abuse. But he also understood the social issues that were involved. Ultrasound machine sales had enormous potential to help maintain GE's market-leading position in India. But should the company step back from its aggressive sales strategy? How could Raja and the company alleviate the growing discontent among critics and the media against the practice of prenatal sex determination testing using GE's ultrasound machines? What additional efforts did GE need to make to prove its intentions of promoting prenatal care? What other efforts should the company make to stop the illicit prenatal gender determination and resulting abortions? How could he protect the as yet untarnished image of GE as a responsible corporation going forward?


Case Authors : Jared Harris, Mayank Jain, Jenny Mead

Topic : Global Business

Related Areas : Cross-cultural management, Ethics, Social responsibility




Calculating Net Present Value (NPV) at 6% for GE Healthcare in India: An (Ultra)Sound Strategy? Case Study


Years              Cash Flow     Net Cash Flow     Cumulative    
Cash Flow
Discount Rate
@ 6 %
Discounted
Cash Flows
Year 0 (10008652) -10008652 - -
Year 1 3444806 -6563846 3444806 0.9434 3249817
Year 2 3958123 -2605723 7402929 0.89 3522715
Year 3 3950376 1344653 11353305 0.8396 3316812
Year 4 3244171 4588824 14597476 0.7921 2569687
TOTAL 14597476 12659032




The Net Present Value at 6% discount rate is 2650380

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. Internal Rate of Return
3. Net Present Value
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. Magnitude of both incoming and outgoing cash flows – Projects can be capital intensive, time intensive, or both. Ultrasound Prenatal 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 Ultrasound Prenatal have higher preference for cash returns over 4-5 years rather than 10-15 years given the nature of the volatility in the industry.






Formula and Steps to Calculate Net Present Value (NPV) of GE Healthcare in India: An (Ultra)Sound Strategy?

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 Global Business 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 Ultrasound Prenatal 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 Ultrasound Prenatal 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 (10008652) -10008652 - -
Year 1 3444806 -6563846 3444806 0.8696 2995483
Year 2 3958123 -2605723 7402929 0.7561 2992910
Year 3 3950376 1344653 11353305 0.6575 2597436
Year 4 3244171 4588824 14597476 0.5718 1854865
TOTAL 10440695


The Net NPV after 4 years is 432043

(10440695 - 10008652 )








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 (10008652) -10008652 - -
Year 1 3444806 -6563846 3444806 0.8333 2870672
Year 2 3958123 -2605723 7402929 0.6944 2748697
Year 3 3950376 1344653 11353305 0.5787 2286097
Year 4 3244171 4588824 14597476 0.4823 1564511
TOTAL 9469977


The Net NPV after 4 years is -538675

At 20% discount rate the NPV is negative (9469977 - 10008652 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Ultrasound Prenatal 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 Ultrasound Prenatal has a NPV value higher than Zero then finance managers at Ultrasound Prenatal 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 Ultrasound Prenatal, then the stock price of the Ultrasound Prenatal 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 Ultrasound Prenatal 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 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.

Understanding of risks involved in the project.

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 GE Healthcare in India: An (Ultra)Sound Strategy?

References & Further Readings

Jared Harris, Mayank Jain, Jenny Mead (2018), "GE Healthcare in India: An (Ultra)Sound Strategy? Harvard Business Review Case Study. Published by HBR Publications.


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