Managing Linen at Apollo Hospitals 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 Managing Linen at Apollo Hospitals case study

At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. Managing Linen at Apollo Hospitals case study is a Harvard Business School (HBR) case study written by Apoorva Sara Prakash, Muthu Solayappan, Dinesh Kumar Unnikrishnan. The Managing Linen at Apollo Hospitals (referred as “Linen Apollo” 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, Operations management.

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 Managing Linen at Apollo Hospitals Case Study

The case describes the use of linen at the Apollo hospitals. Apollo Hospital in Bannerghatta Road Bangalore is a tertiary care hospital with a capacity of 250 beds. In 2013, Apollo Hospital spent INR 5.1 million on managing bed lines (consisting of bed sheets and pillow cover). Dr Ananth N Rao, head of quality at the Apollo hospitals thought that the cost of linen management can be optimized using mathematical programming techniques which can have a significant impact on the bottom-line of the hospital. Each bed in the hospital is given two bed sheets and a pillow cover; however, there was 2% additional usage of linen owing to various reasons such as linen becoming dirty, wet, etc. Apollo hospital keeps a safety stock of linen for two days and any linen sent for washing is returned on day d + 2. The objective is to develop a mathematical programming model to minimize the total cost of linen management.

Case Authors : Apoorva Sara Prakash, Muthu Solayappan, Dinesh Kumar Unnikrishnan

Topic : Leadership & Managing People

Related Areas : Operations management

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Calculating Net Present Value (NPV) at 6% for Managing Linen at Apollo Hospitals Case Study

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 6 %	Discounted Cash Flows
Year 0	(10022097)	-10022097	-	-
Year 1	3461078	-6561019	3461078	0.9434	3265168
Year 2	3969169	-2591850	7430247	0.89	3532546
Year 3	3945744	1353894	11375991	0.8396	3312923
Year 4	3246731	4600625	14622722	0.7921	2571715
TOTAL			14622722		12682352

The Net Present Value at 6% discount rate is 2660255

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. Net Present Value
2. Profitability Index
3. Internal Rate of Return
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. Timing of the expected cash flows – stockholders of Linen Apollo 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. Linen Apollo 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 Managing Linen at Apollo Hospitals

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 Linen Apollo 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 Linen Apollo 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	(10022097)	-10022097	-	-
Year 1	3461078	-6561019	3461078	0.8696	3009633
Year 2	3969169	-2591850	7430247	0.7561	3001262
Year 3	3945744	1353894	11375991	0.6575	2594391
Year 4	3246731	4600625	14622722	0.5718	1856329
TOTAL					10461615

The Net NPV after 4 years is 439518

(10461615 - 10022097 )

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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	(10022097)	-10022097	-	-
Year 1	3461078	-6561019	3461078	0.8333	2884232
Year 2	3969169	-2591850	7430247	0.6944	2756367
Year 3	3945744	1353894	11375991	0.5787	2283417
Year 4	3246731	4600625	14622722	0.4823	1565746
TOTAL					9489762

The Net NPV after 4 years is -532335

At 20% discount rate the NPV is negative (9489762 - 10022097 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Linen Apollo 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 Linen Apollo has a NPV value higher than Zero then finance managers at Linen Apollo 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 Linen Apollo, then the stock price of the Linen Apollo 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 Linen Apollo 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 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.

Understanding of risks involved in 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.

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Negotiation Strategy of Managing Linen at Apollo Hospitals

References & Further Readings

Apoorva Sara Prakash, Muthu Solayappan, Dinesh Kumar Unnikrishnan (2018), "Managing Linen at Apollo Hospitals Harvard Business Review Case Study. Published by HBR Publications.