Alan Kendricks at Cardiology Associates 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 Alan Kendricks at Cardiology Associates case study

At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. Alan Kendricks at Cardiology Associates case study is a Harvard Business School (HBR) case study written by Boris Groysberg, Colleen Kaftan, Wilfred S. McCalla Jr.. The Alan Kendricks at Cardiology Associates (referred as “Kendricks Cardiology” from here on) case study provides evaluation & decision scenario in field of Leadership & Managing People. It also touches upon business topics such as - Value proposition, Human resource management, Leadership, Managing people, Organizational culture, Work-life balance.

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 Alan Kendricks at Cardiology Associates Case Study

Alan Kendricks struggles to address many challenges facing him as a recently promoted medical director for Cardiology Associates at Southeastern Pennsylvania University Hospital. He must balance his time taking care of patients, running a practice, managing up, down, and laterally, managing stars with little formal authority, allocating resources fairly, developing his people, providing strategy and direction, building an organization, and spending time with his family. Offers insights into the dilemmas of a "producing manager," a person who is simultaneously responsible for producing and managing.

Case Authors : Boris Groysberg, Colleen Kaftan, Wilfred S. McCalla Jr.

Topic : Leadership & Managing People

Related Areas : Human resource management, Leadership, Managing people, Organizational culture, Work-life balance

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Calculating Net Present Value (NPV) at 6% for Alan Kendricks at Cardiology Associates Case Study

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 6 %	Discounted Cash Flows
Year 0	(10022599)	-10022599	-	-
Year 1	3453239	-6569360	3453239	0.9434	3257773
Year 2	3966312	-2603048	7419551	0.89	3530004
Year 3	3964870	1361822	11384421	0.8396	3328981
Year 4	3251618	4613440	14636039	0.7921	2575586
TOTAL			14636039		12692344

The Net Present Value at 6% discount rate is 2669745

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. 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. Kendricks Cardiology 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 Kendricks Cardiology have higher preference for cash returns over 4-5 years rather than 10-15 years given the nature of the volatility in the industry.

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Formula and Steps to Calculate Net Present Value (NPV) of Alan Kendricks at Cardiology Associates

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 Leadership & Managing People 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 Kendricks Cardiology 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 Kendricks Cardiology 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	(10022599)	-10022599	-	-
Year 1	3453239	-6569360	3453239	0.8696	3002817
Year 2	3966312	-2603048	7419551	0.7561	2999102
Year 3	3964870	1361822	11384421	0.6575	2606966
Year 4	3251618	4613440	14636039	0.5718	1859123
TOTAL					10468008

The Net NPV after 4 years is 445409

(10468008 - 10022599 )

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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	(10022599)	-10022599	-	-
Year 1	3453239	-6569360	3453239	0.8333	2877699
Year 2	3966312	-2603048	7419551	0.6944	2754383
Year 3	3964870	1361822	11384421	0.5787	2294485
Year 4	3251618	4613440	14636039	0.4823	1568103
TOTAL					9494670

The Net NPV after 4 years is -527929

At 20% discount rate the NPV is negative (9494670 - 10022599 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Kendricks Cardiology 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 Kendricks Cardiology has a NPV value higher than Zero then finance managers at Kendricks Cardiology 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 Kendricks Cardiology, then the stock price of the Kendricks Cardiology 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 Kendricks Cardiology 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 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.

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 Alan Kendricks at Cardiology Associates

References & Further Readings

Boris Groysberg, Colleen Kaftan, Wilfred S. McCalla Jr. (2018), "Alan Kendricks at Cardiology Associates Harvard Business Review Case Study. Published by HBR Publications.