Help the World See: Self-Sustaining Eye Care in Belize 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 Help the World See: Self-Sustaining Eye Care in Belize case study

At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. Help the World See: Self-Sustaining Eye Care in Belize case study is a Harvard Business School (HBR) case study written by J. Gregory Dees, Jeffrey Orenstein, Jaan Elias. The Help the World See: Self-Sustaining Eye Care in Belize (referred as “Bcvi Eye” from here on) case study provides evaluation & decision scenario in field of Innovation & Entrepreneurship. It also touches upon business topics such as - Value proposition, Managing people, Social enterprise.

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 Help the World See: Self-Sustaining Eye Care in Belize Case Study

In 1992, Help the World See (HTWS), a U.S. nonprofit organization dedicated to improving eye care in developing countries, established permanent, self-sustaining eye care clinics in Belize in conjunction with the Belize Council for the Visually Impaired (BCVI). The HTWS/BCVI program trained and outfitted five Regional Field Officers (RFO) to identify basic eye diseases, provide education, and sell low-cost eyeglasses. By 1996, the program had become a significant part of Belize's eye care system and was approaching the break-even point. However, the program's success had placed it in jeopardy. Belize's ophthalmologists, who had assented to the program in 1992, were concerned about the low-fee competition. They had prevailed on the Medical Council, the body charged with overseeing medical practices within the country, to send two letters to the BCVI, pointing out that only licensed optometrists and ophthalmologists could prescribe eyeglasses and perform eye exams. If enforced against the HTWS/BCVI RFOs, the rule would cripple the program. The case opens with HTWS's president Jeff Orenstein and founder Dr. Wayne Cannon preparing for a meeting with the Belizean Ministry of Health.

Case Authors : J. Gregory Dees, Jeffrey Orenstein, Jaan Elias

Topic : Innovation & Entrepreneurship

Related Areas : Managing people, Social enterprise

Calculating Net Present Value (NPV) at 6% for Help the World See: Self-Sustaining Eye Care in Belize Case Study

Years              Cash Flow     Net Cash Flow     Cumulative    
Cash Flow
Discount Rate
@ 6 %
Cash Flows
Year 0 (10023282) -10023282 - -
Year 1 3461188 -6562094 3461188 0.9434 3265272
Year 2 3963602 -2598492 7424790 0.89 3527592
Year 3 3945177 1346685 11369967 0.8396 3312447
Year 4 3247492 4594177 14617459 0.7921 2572318
TOTAL 14617459 12677628

The Net Present Value at 6% discount rate is 2654346

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. Payback Period
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 Bcvi Eye 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. Bcvi Eye 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 Help the World See: Self-Sustaining Eye Care in Belize

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 Innovation & Entrepreneurship 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 Bcvi Eye 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 Bcvi Eye 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 %
Cash Flows
Year 0 (10023282) -10023282 - -
Year 1 3461188 -6562094 3461188 0.8696 3009729
Year 2 3963602 -2598492 7424790 0.7561 2997053
Year 3 3945177 1346685 11369967 0.6575 2594018
Year 4 3247492 4594177 14617459 0.5718 1856764
TOTAL 10457563

The Net NPV after 4 years is 434281

(10457563 - 10023282 )

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 %
Cash Flows
Year 0 (10023282) -10023282 - -
Year 1 3461188 -6562094 3461188 0.8333 2884323
Year 2 3963602 -2598492 7424790 0.6944 2752501
Year 3 3945177 1346685 11369967 0.5787 2283089
Year 4 3247492 4594177 14617459 0.4823 1566113
TOTAL 9486026

The Net NPV after 4 years is -537256

At 20% discount rate the NPV is negative (9486026 - 10023282 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Bcvi Eye 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 Bcvi Eye has a NPV value higher than Zero then finance managers at Bcvi Eye 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 Bcvi Eye, then the stock price of the Bcvi Eye 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 Bcvi Eye 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 will be a multi year spillover effect of various taxation regulations.

What can impact the cash flow of 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 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.

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.

References & Further Readings

J. Gregory Dees, Jeffrey Orenstein, Jaan Elias (2018), "Help the World See: Self-Sustaining Eye Care in Belize Harvard Business Review Case Study. Published by HBR Publications.