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Cost-Benefit Analysis
Deciding, Quantitatively, Whether to go Ahead
(Also known as CBA and Benefit-Cost Analysis)
http://www.mindtools.com/pages/article/newTED_08.htm
Imagine that you've recently taken on a new project, and your
people are struggling to keep up with the increased workload.
You are therefore considering whether to hire a new team
member. Clearly, the benefits of hiring a new person need to
significantly outweigh the associated costs.
This is where Cost-Benefit Analysis is useful.
Note:
Cost-Benefit Analysis is a quick and simple technique that you
can use for non-critical financial decisions. Where decisions are
mission-critical or large sums of money are involved, other
approaches – such as use of Net Present Values and Internal
Rates of Return – are often more appropriate.
About the Tool
Jules Dupuit, a French engineer, first introduced the concept of
Cost-Benefit Analysis in the 1930s. It became popular in the
1950s as a simple way of weighing up project costs and
benefits, to determine whether to go ahead with a project.
As its name suggests, Cost-Benefit Analysis involves adding up
the benefits of a course of action, and then comparing these
with the costs associated with it.
The results of the analysis are often expressed as a payback
period – this is the time it takes for benefits to repay costs.
Many people who use it look for payback in less than a specific
period – for example, three years.
You can use the technique in a wide variety of situations. For
example, when you are:
· Deciding whether to hire new team members.
· Evaluating a new project or change initiative.
· Determining the feasibility of a capital purchase.
However, bear in mind that it is best for making quick and
simple financial decisions. More robust approaches are
commonly used for more complex, business-critical or high cost
decisions.
How to Use the Tool
Follow these steps to do a Cost-Benefit Analysis.
Step One: Brainstorm Costs and Benefits
First, take time to brainstorm all of the costs associated with the
project, and make a list of these. Then, do the same for all of
the benefits of the project. Can you think of any unexpected
costs? And are there benefits that you may not initially have
anticipated?
When you come up with the costs and benefits, think about the
lifetime of the project. What are the costs and benefits likely to
be over time?
Step Two: Assign a Monetary Value to the Costs
Costs include the costs of physical resources needed, as well as
the cost of the human effort involved in all phases of a project.
Costs are often relatively easy to estimate (compared with
revenues).
It's important that you think about as many related costs as you
can. For example, what will any training cost? Will there be a
decrease in productivity while people are learning a new system
or technology, and how much will this cost?
Remember to think about costs that will continue to be incurred
once the project is finished. For example, consider whether you
will need additional staff, if your team will need ongoing
training, or if you'll have increased overheads.
Step Three: Assign a Monetary Value to the Benefits
This step is less straightforward than step two! Firstly, it's often
very difficult to predict revenues accurately, especially for new
products. Secondly, along with the financial benefits that you
anticipate, there are often intangible, or soft, benefits that are
important outcomes of the project.
For instance, what is the impact on the environment, employee
satisfaction, or health and safety? What is the monetary value of
that impact?
As an example, is preserving an ancient monument worth
$500,000, or is it worth $5,000,000 because of its historical
importance? Or, what is the value of stress-free travel to work
in the morning? Here, it's important to consult with other
stakeholders and decide how you'll value these intangible items.
Step Four: Compare Costs and Benefits
Finally, compare the value of your costs to the value of your
benefits, and use this analysis to decide your course of action.
To do this, calculate your total costs and your total benefits,
and compare the two values to determine whether your benefits
outweigh your costs. At this stage it's important to consider the
payback time, to find out how long it will take for you to reach
the break even point – the point in time at which the benefits
have just repaid the costs.
For simple examples, where the same benefits are received each
period, you can calculate the payback period by dividing the
projected total cost of the project by the projected total
revenues:
Total cost / total revenue (or benefits) = length of time
(payback period).
Example
Custom Graphic Works has been operating for just over a year,
and sales are exceeding targets. Currently, two designers are
working full-time, and the owner is considering increasing
capacity to meet demand. (This would involve leasing more
space and hiring two new designers.)
He decides to complete a Cost-Benefit Analysis to explore his
choices.
Assumptions
· Currently, the owner of the company has more work than he
can cope with, and he is outsourcing to other design firms at a
cost of $50 an hour. The company outsources an average of 100
hours of work each month.
· He estimates that revenue will increase by 50 percent with
increased capacity.
· Per-person production will increase by 10 percent with more
working space.
· The analysis horizon is one year: that is, he expects benefits to
accrue within the year.
Costs
Category
Details
Cost in First Year
Lease
750 square feet available next door at $18 per square foot
$13,500
Leasehold improvements
Knock out walls and reconfigure office space
$15,000
Hire two more designers
Salary, including benefits
Recruitment costs
Orientation and training
$75,000
$11,250
$3,000
Two additional workstations
Furniture and hardware
Software licenses
$6,000
$1,000
Construction downtime
Two weeks at approximately $7,500 revenue per week
$15,000
Total
$139,750
Benefits
Benefit
Benefit Within
12 Months
50 percent revenue increase
$195,000
Paying in-house designers $15 an hour, versus $50 an hour
outsourcing (100 hours per month, on average: savings equals
$3,500 a month)
$42,000
10 percent improved productivity per designer ($7,500 + $3,750
= $11,250 revenue per week with a 10 percent increase =
$1,125/week)
$58,500
Improved customer service and retention as a result of 100
percent in-house design
$10,000
Total
$305,500
He calculates the payback time as shown below:
$139,750 / $305,500 = 0.46 of a year, or approximately 5.5
months.
Inevitably, the estimates of the benefit are subjective, and there
is a degree of uncertainty associated with the anticipated
revenue increase. Despite this, the owner of Custom Graphic
Works decides to go ahead with the expansion and hiring, given
the extent to which the benefits outweigh the costs within the
first year.
Flaws of Cost-Benefit Analysis
Cost-Benefit Analysis struggles as an approach where a project
has cash flows that come in over a number of periods of time,
particularly where returns vary from period to period. In these
cases, use Net Present Value (NPV) and Internal Rate of Return
(IRR) calculations together to evaluate the project, rather than
using Cost-Benefit Analysis. (These also have the advantage of
bringing "time value of money" into the calculation.)
Also, the revenue that will be generated by a project can be very
hard to predict, and the value that people place on intangible
benefits can be very subjective. This can often make the
assessment of possible revenues unreliable (this is a flaw in
many approaches to financial evaluation). So, how realistic and
objective are the benefit values used?
Key Points
Cost-benefit analysis is a relatively straightforward tool for
deciding whether to pursue a project.
To use the tool, first list all the anticipated costs associated
with the project, and then estimate the benefits that you'll
receive from it.
Where benefits are received over time, work out the time it will
take for the benefits to repay the costs.
You can carry out an analysis using only financial costs and
benefits. However, you may decide to include intangible items
within the analysis. As you must estimate a value for these
items, this inevitably brings more subjectivity into the process.
Cost-Benefit Analysis
Deciding, Quantitatively, Whether to go Ahead
(Also known as CBA and Benefit-Cost Analysis)
http://www.mindtools.com/pages/article/newTED_08.htm
Imagine that you've recently taken on a new project, and your
people are struggling to keep up with the increased workload.
You are therefore considering whether to hire a new team
member. Clearly, the benefits of hiring a new person need to
significantly outweigh the associated costs.
This is where Cost-Benefit Analysis is useful.
Note:
Cost-Benefit Analysis is a quick and simple technique that you
can use for non-critical financial decisions. Where decisions are
mission-critical or large sums of money are involved, other
approaches – such as use of Net Present Values and Internal
Rates of Return – are often more appropriate.
About the Tool
Jules Dupuit, a French engineer, first introduced the concept of
Cost-Benefit Analysis in the 1930s. It became popular in the
1950s as a simple way of weighing up project costs and
benefits, to determine whether to go ahead with a project.
As its name suggests, Cost-Benefit Analysis involves adding up
the benefits of a course of action, and then comparing these
with the costs associated with it.
The results of the analysis are often expressed as a payback
period – this is the time it takes for benefits to repay costs.
Many people who use it look for payback in less than a specific
period – for example, three years.
You can use the technique in a wide variety of situations. For
example, when you are:
· Deciding whether to hire new team members.
· Evaluating a new project or change initiative.
· Determining the feasibility of a capital purchase.
However, bear in mind that it is best for making quick and
simple financial decisions. More robust approaches are
commonly used for more complex, business-critical or high cost
decisions.
How to Use the Tool
Follow these steps to do a Cost-Benefit Analysis.
Step One: Brainstorm Costs and Benefits
First, take time to brainstorm all of the costs associated with the
project, and make a list of these. Then, do the same for all of
the benefits of the project. Can you think of any unexpected
costs? And are there benefits that you may not initially have
anticipated?
When you come up with the costs and benefits, think about the
lifetime of the project. What are the costs and benefits likely to
be over time?
Step Two: Assign a Monetary Value to the Costs
Costs include the costs of physical resources needed, as well as
the cost of the human effort involved in all phases of a project.
Costs are often relatively easy to estimate (compared with
revenues).
It's important that you think about as many related costs as you
can. For example, what will any training cost? Will there be a
decrease in productivity while people are learning a new system
or technology, and how much will this cost?
Remember to think about costs that will continue to be incurred
once the project is finished. For example, consider whether you
will need additional staff, if your team will need ongoing
training, or if you'll have increased overheads.
Step Three: Assign a Monetary Value to the Benefits
This step is less straightforward than step two! Firstly, it's often
very difficult to predict revenues accurately, especially for new
products. Secondly, along with the financial benefits that you
anticipate, there are often intangible, or soft, benefits that are
important outcomes of the project.
For instance, what is the impact on the environment, employee
satisfaction, or health and safety? What is the monetary value of
that impact?
As an example, is preserving an ancient monument worth
$500,000, or is it worth $5,000,000 because of its historical
importance? Or, what is the value of stress-free travel to work
in the morning? Here, it's important to consult with other
stakeholders and decide how you'll value these intangible items.
Step Four: Compare Costs and Benefits
Finally, compare the value of your costs to the value of your
benefits, and use this analysis to decide your course of action.
To do this, calculate your total costs and your total benefits,
and compare the two values to determine whether your benefits
outweigh your costs. At this stage it's important to consider the
payback time, to find out how long it will take for you to reach
the break even point – the point in time at which the benefits
have just repaid the costs.
For simple examples, where the same benefits are received each
period, you can calculate the payback period by dividing the
projected total cost of the project by the projected total
revenues:
Total cost / total revenue (or benefits) = length of time
(payback period).
Example
Custom Graphic Works has been operating for just over a year,
and sales are exceeding targets. Currently, two designers are
working full-time, and the owner is considering increasing
capacity to meet demand. (This would involve leasing more
space and hiring two new designers.)
He decides to complete a Cost-Benefit Analysis to explore his
choices.
Assumptions
· Currently, the owner of the company has more work than he
can cope with, and he is outsourcing to other design firms at a
cost of $50 an hour. The company outsources an average of 100
hours of work each month.
· He estimates that revenue will increase by 50 percent with
increased capacity.
· Per-person production will increase by 10 percent with more
working space.
· The analysis horizon is one year: that is, he expects benefits to
accrue within the year.
Costs
Category
Details
Cost in First Year
Lease
750 square feet available next door at $18 per square foot
$13,500
Leasehold improvements
Knock out walls and reconfigure office space
$15,000
Hire two more designers
Salary, including benefits
Recruitment costs
Orientation and training
$75,000
$11,250
$3,000
Two additional workstations
Furniture and hardware
Software licenses
$6,000
$1,000
Construction downtime
Two weeks at approximately $7,500 revenue per week
$15,000
Total
$139,750
Benefits
Benefit
Benefit Within
12 Months
50 percent revenue increase
$195,000
Paying in-house designers $15 an hour, versus $50 an hour
outsourcing (100 hours per month, on average: savings equals
$3,500 a month)
$42,000
10 percent improved productivity per designer ($7,500 + $3,750
= $11,250 revenue per week with a 10 percent increase =
$1,125/week)
$58,500
Improved customer service and retention as a result of 100
percent in-house design
$10,000
Total
$305,500
He calculates the payback time as shown below:
$139,750 / $305,500 = 0.46 of a year, or approximately 5.5
months.
Inevitably, the estimates of the benefit are subjective, and there
is a degree of uncertainty associated with the anticipated
revenue increase. Despite this, the owner of Custom Graphic
Works decides to go ahead with the expansion and hiring, given
the extent to which the benefits outweigh the costs within the
first year.
Flaws of Cost-Benefit Analysis
Cost-Benefit Analysis struggles as an approach where a project
has cash flows that come in over a number of periods of time,
particularly where returns vary from period to period. In these
cases, use Net Present Value (NPV) and Internal Rate of Return
(IRR) calculations together to evaluate the project, rather than
using Cost-Benefit Analysis. (These also have the advantage of
bringing "time value of money" into the calculation.)
Also, the revenue that will be generated by a project can be very
hard to predict, and the value that people place on intangible
benefits can be very subjective. This can often make the
assessment of possible revenues unreliable (this is a flaw in
many approaches to financial evaluation). So, how realistic and
objective are the benefit values used?
Key Points
Cost-benefit analysis is a relatively straightforward tool for
deciding whether to pursue a project.
To use the tool, first list all the anticipated costs associated
with the project, and then estimate the benefits that you'll
receive from it.
Where benefits are received over time, work out the time it will
take for the benefits to repay the costs.
You can carry out an analysis using only financial costs and
benefits. However, you may decide to include intangible items
within the analysis. As you must estimate a value for these
items, this inevitably brings more subjectivity into the process.
Last Year BudgetCoppin State Regional Health CenterHealth
Information Management Department
BudgetSALARIES$471,040.00EDUCATION$1,200.00MAINTE
NANCE
CONTRACTS$25,000.00REPAIRS$3,500.00FOOD$300.00STO
RAGE$7,200.00POSTAGE$1,200.00OFFICE
SUPPLIES$36,000.00PROFESSIONAL
DUES$250.00TRAVEL$1,800.00TOTAL$547,490.00AVERAG
E HOURLY RATE$18.87REVENUE$78,000.00
Salaries BudgetPOSITIONSALARYHOURLY
RATEYearlyDIRECTOR$80,000.00DRG
COORDINATOR$28.00$58,240.00CODER$22.00$45,760.00CO
DER$22.00$45,760.00CODER$18.00$37,440.00SUPERVISOR$
20.00$41,600.00CLERK$12.00$24,960.00CLERK$12.00$24,96
0.00CLERK$12.00$24,960.00ROI CLERK$15.00$31,200.00ROI
CLERK$15.00$31,200.00VITAL STATS
CLERK$12.00$24,960.00$391,040.00DIRECTOR SALARY
ADDED BACK IN$80,000.00TOTAL SALARIES FOR
DEPARTMENT$471,040.00
Monthly
ExpensesJANFEBMARAPRMAYJUNJULAUGSEPOCTNOVDE
CYTDSALARIES$40,006.14$36,134.58$40,006.14$38,715.62$
40,006.14$38,715.62$40,006.14$40,006.14$40,006.14$40,006.1
4$38,715.62$40,006.14$471,040.00EDUCATION$100.00$100.0
0$100.00$100.00$100.00$100.00$100.00$100.00$100.00$100.0
0$100.00$100.00$1,200.00MAINTENANCE
CONTRACTS$2,083.33$2,083.33$2,083.33$2,083.33$2,083.33
$2,083.33$2,083.33$2,083.33$2,083.33$2,083.33$2,083.33$2,0
83.33$25,000.00REPAIRS$291.67$291.67$291.67$291.67$291.
67$291.67$291.67$291.67$291.67$291.67$291.67$291.67$3,50
0.00FOOD$25.00$25.00$25.00$25.00$25.00$25.00$25.00$25.0
0$25.00$25.00$25.00$25.00$300.00STORAGE$600.00$600.00$
600.00$600.00$600.00$600.00$600.00$600.00$600.00$600.00$
600.00$600.00$7,200.00POSTAGE$48.00$48.00$48.00$48.00$
48.00$48.00$48.00$48.00$48.00$48.00$48.00$48.00$576.00OF
FICE
SUPPLIES$3,000.00$3,000.00$3,000.00$3,000.00$3,000.00$3,0
00.00$3,000.00$3,000.00$3,000.00$3,000.00$3,000.00$3,000.0
0$36,000.00*PROFESSIONAL
DUES$20.83$20.83$20.83$20.83$20.83$20.83$20.83$20.83$20
.83$20.83$20.83$20.83$250.00TRAVEL$150.00$150.00$150.0
0$150.00$150.00$150.00$150.00$150.00$150.00$150.00$150.0
0$150.00$1,800.00TOTAL$46,324.97$42,453.41$46,324.97$45,
034.45$46,324.97$45,034.45$46,324.97$46,324.97$46,324.97$
46,324.97$45,034.45$46,324.97$548,156.52AVERAGE
HOURLY
RATEREVENUE$6,500.00$6,500.00$6,500.00$6,500.00$6,500.
00$6,500.00$6,500.00$6,500.00$6,500.00$6,500.00$6,500.00$6
,500.00$78,000.00
Capstone Scenario- HIM 305
Coppin State Regional Health Center is a 270-bed, not-for-
profit community hospital. Its largest percentage of patients
consists of mothers and newborns, followed by a variety of
cardiovascular-related admissions. It has an emergency
department staffed by hospital employees. Coppin State
Regional Health Center’s fiscal year follows the calendar year,
ending December 31. In August, Coppin State Regional Health
Center began its year-end budget process by establishing its
financial assumptions for the following two years.
Administration distributed operational and capital budget
compilation packages to department managers for completion
and return by September 30.
Financial Assumptions:
Coppin State Regional Health Center Administration assumed
that revenue would remain constant, that it would continue its
existing contracts with payers, that its Medicare population
percentage would not change, and that no major infrastructure
maintenance would be required in the upcoming fiscal year.
· No major capital projects were anticipated.
· In its operational budget, administration plans to include
resources for a Joint Commission steering committee and
related activities to prepare for the anticipated accreditation
visit in the subsequent year.
Coppin State Regional Health Center does not have a large
marketing department. It has one marketing professional on
staff whose responsibilities include the development and
publishing of brochures and coordination of patient satisfaction
surveys, which are compiled and analyzed by an outside vendor.
In the past two years, there has been a slight, but continuing,
decline in patient satisfaction among maternity patients.
Suggestions for improvement have varied, but common
complaints center on the lack of soothing ambiance in labor and
delivery and the hospital policy prohibiting overnight visitors.
The maternity and newborn departments have been very
concerned about declining patient satisfaction. They are
worried that the current year’s slight decline in maternity
admissions is the result of that dissatisfaction and that patients
are traveling a little further to give birth at a neighboring
medical center, at which some of their physicians also have
privileges.
· The departments would like to renovate the maternity and
newborn wing, forming a women’s center with increased
emphasis on wellness and ancillary services. This would be a
two-year capital project that would require marketing support
and some minor disruption of services during construction.
The cardiology department staff is very excited. They have just
learned that a well-respected cardiologist has retired to the area
and is exploring the idea of opening a small consulting practice.
The cardiologist has not yet applied for privileges at any area
hospitals, but it is known that she is used to working in a
facility with its own cardiac catheterization lab. Because the
current chief of the medical staff at Coppin State Regional
Health Center is a personal friend of the cardiologist, the
cardiology department believes that she could be lured on staff
if the hospital had its own lab.
· Based on the volume of patients that Coppin State Regional
Health Center currently sends out to another facility for cardiac
catheterization, the cardiology department believes that patient
care would be facilitated by the expansion and that the
increased revenue would help justify the cost.
The HIM department has recently lost several employees to
retirement and promotions with the facility. It is currently
down two coders and a file clerk, and has reduced its weekend
coverage to one person, day shift only. Transcription is handled
largely by the department, with an outside service processing
any overflow.
· The HIM department would like to outsource all of its
transcription and move to a Web-based coding system that
would allow the coders to telecommute.
· These changes would also require the implementation of an
Electronic Record System (EHR).
All three departments submitted capital budget requests for the
projects described.
Budget Considerations (to be submitted in a Word document
with spreadsheets):
1. What things should be considered in conducting a cost-
benefit analysis on each project?
2. At this point in your decision making which request is most
appropriate? Request for Information, Request for Proposal or
Request for a Quote? Explain your answer. Develop a request
for proposal to send to the transcription and coding services.
3. If the hospital can only approve one of the proposed projects,
which do you think has the best chance of being approved?
Why?
4. If you were the director of the HIM department, how would
you justify your department’s project so that it is presented
most favorably? What are the benefits to selecting this project?

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  • 1. Cost-Benefit Analysis Deciding, Quantitatively, Whether to go Ahead (Also known as CBA and Benefit-Cost Analysis) http://www.mindtools.com/pages/article/newTED_08.htm Imagine that you've recently taken on a new project, and your people are struggling to keep up with the increased workload. You are therefore considering whether to hire a new team member. Clearly, the benefits of hiring a new person need to significantly outweigh the associated costs. This is where Cost-Benefit Analysis is useful. Note: Cost-Benefit Analysis is a quick and simple technique that you can use for non-critical financial decisions. Where decisions are mission-critical or large sums of money are involved, other approaches – such as use of Net Present Values and Internal Rates of Return – are often more appropriate. About the Tool Jules Dupuit, a French engineer, first introduced the concept of Cost-Benefit Analysis in the 1930s. It became popular in the 1950s as a simple way of weighing up project costs and benefits, to determine whether to go ahead with a project. As its name suggests, Cost-Benefit Analysis involves adding up the benefits of a course of action, and then comparing these with the costs associated with it. The results of the analysis are often expressed as a payback period – this is the time it takes for benefits to repay costs. Many people who use it look for payback in less than a specific period – for example, three years. You can use the technique in a wide variety of situations. For example, when you are: · Deciding whether to hire new team members. · Evaluating a new project or change initiative. · Determining the feasibility of a capital purchase.
  • 2. However, bear in mind that it is best for making quick and simple financial decisions. More robust approaches are commonly used for more complex, business-critical or high cost decisions. How to Use the Tool Follow these steps to do a Cost-Benefit Analysis. Step One: Brainstorm Costs and Benefits First, take time to brainstorm all of the costs associated with the project, and make a list of these. Then, do the same for all of the benefits of the project. Can you think of any unexpected costs? And are there benefits that you may not initially have anticipated? When you come up with the costs and benefits, think about the lifetime of the project. What are the costs and benefits likely to be over time? Step Two: Assign a Monetary Value to the Costs Costs include the costs of physical resources needed, as well as the cost of the human effort involved in all phases of a project. Costs are often relatively easy to estimate (compared with revenues). It's important that you think about as many related costs as you can. For example, what will any training cost? Will there be a decrease in productivity while people are learning a new system or technology, and how much will this cost? Remember to think about costs that will continue to be incurred once the project is finished. For example, consider whether you will need additional staff, if your team will need ongoing training, or if you'll have increased overheads. Step Three: Assign a Monetary Value to the Benefits This step is less straightforward than step two! Firstly, it's often very difficult to predict revenues accurately, especially for new products. Secondly, along with the financial benefits that you anticipate, there are often intangible, or soft, benefits that are important outcomes of the project. For instance, what is the impact on the environment, employee satisfaction, or health and safety? What is the monetary value of
  • 3. that impact? As an example, is preserving an ancient monument worth $500,000, or is it worth $5,000,000 because of its historical importance? Or, what is the value of stress-free travel to work in the morning? Here, it's important to consult with other stakeholders and decide how you'll value these intangible items. Step Four: Compare Costs and Benefits Finally, compare the value of your costs to the value of your benefits, and use this analysis to decide your course of action. To do this, calculate your total costs and your total benefits, and compare the two values to determine whether your benefits outweigh your costs. At this stage it's important to consider the payback time, to find out how long it will take for you to reach the break even point – the point in time at which the benefits have just repaid the costs. For simple examples, where the same benefits are received each period, you can calculate the payback period by dividing the projected total cost of the project by the projected total revenues: Total cost / total revenue (or benefits) = length of time (payback period). Example Custom Graphic Works has been operating for just over a year, and sales are exceeding targets. Currently, two designers are working full-time, and the owner is considering increasing capacity to meet demand. (This would involve leasing more space and hiring two new designers.) He decides to complete a Cost-Benefit Analysis to explore his choices. Assumptions · Currently, the owner of the company has more work than he can cope with, and he is outsourcing to other design firms at a cost of $50 an hour. The company outsources an average of 100 hours of work each month. · He estimates that revenue will increase by 50 percent with increased capacity.
  • 4. · Per-person production will increase by 10 percent with more working space. · The analysis horizon is one year: that is, he expects benefits to accrue within the year. Costs Category Details Cost in First Year Lease 750 square feet available next door at $18 per square foot $13,500 Leasehold improvements Knock out walls and reconfigure office space $15,000 Hire two more designers Salary, including benefits Recruitment costs Orientation and training $75,000 $11,250 $3,000 Two additional workstations Furniture and hardware Software licenses $6,000 $1,000 Construction downtime Two weeks at approximately $7,500 revenue per week $15,000 Total $139,750 Benefits Benefit Benefit Within
  • 5. 12 Months 50 percent revenue increase $195,000 Paying in-house designers $15 an hour, versus $50 an hour outsourcing (100 hours per month, on average: savings equals $3,500 a month) $42,000 10 percent improved productivity per designer ($7,500 + $3,750 = $11,250 revenue per week with a 10 percent increase = $1,125/week) $58,500 Improved customer service and retention as a result of 100 percent in-house design $10,000 Total $305,500 He calculates the payback time as shown below: $139,750 / $305,500 = 0.46 of a year, or approximately 5.5 months. Inevitably, the estimates of the benefit are subjective, and there is a degree of uncertainty associated with the anticipated revenue increase. Despite this, the owner of Custom Graphic Works decides to go ahead with the expansion and hiring, given the extent to which the benefits outweigh the costs within the first year. Flaws of Cost-Benefit Analysis Cost-Benefit Analysis struggles as an approach where a project has cash flows that come in over a number of periods of time, particularly where returns vary from period to period. In these cases, use Net Present Value (NPV) and Internal Rate of Return (IRR) calculations together to evaluate the project, rather than using Cost-Benefit Analysis. (These also have the advantage of bringing "time value of money" into the calculation.) Also, the revenue that will be generated by a project can be very hard to predict, and the value that people place on intangible benefits can be very subjective. This can often make the
  • 6. assessment of possible revenues unreliable (this is a flaw in many approaches to financial evaluation). So, how realistic and objective are the benefit values used? Key Points Cost-benefit analysis is a relatively straightforward tool for deciding whether to pursue a project. To use the tool, first list all the anticipated costs associated with the project, and then estimate the benefits that you'll receive from it. Where benefits are received over time, work out the time it will take for the benefits to repay the costs. You can carry out an analysis using only financial costs and benefits. However, you may decide to include intangible items within the analysis. As you must estimate a value for these items, this inevitably brings more subjectivity into the process. Cost-Benefit Analysis Deciding, Quantitatively, Whether to go Ahead (Also known as CBA and Benefit-Cost Analysis) http://www.mindtools.com/pages/article/newTED_08.htm Imagine that you've recently taken on a new project, and your people are struggling to keep up with the increased workload. You are therefore considering whether to hire a new team member. Clearly, the benefits of hiring a new person need to significantly outweigh the associated costs. This is where Cost-Benefit Analysis is useful. Note: Cost-Benefit Analysis is a quick and simple technique that you can use for non-critical financial decisions. Where decisions are mission-critical or large sums of money are involved, other approaches – such as use of Net Present Values and Internal Rates of Return – are often more appropriate. About the Tool Jules Dupuit, a French engineer, first introduced the concept of
  • 7. Cost-Benefit Analysis in the 1930s. It became popular in the 1950s as a simple way of weighing up project costs and benefits, to determine whether to go ahead with a project. As its name suggests, Cost-Benefit Analysis involves adding up the benefits of a course of action, and then comparing these with the costs associated with it. The results of the analysis are often expressed as a payback period – this is the time it takes for benefits to repay costs. Many people who use it look for payback in less than a specific period – for example, three years. You can use the technique in a wide variety of situations. For example, when you are: · Deciding whether to hire new team members. · Evaluating a new project or change initiative. · Determining the feasibility of a capital purchase. However, bear in mind that it is best for making quick and simple financial decisions. More robust approaches are commonly used for more complex, business-critical or high cost decisions. How to Use the Tool Follow these steps to do a Cost-Benefit Analysis. Step One: Brainstorm Costs and Benefits First, take time to brainstorm all of the costs associated with the project, and make a list of these. Then, do the same for all of the benefits of the project. Can you think of any unexpected costs? And are there benefits that you may not initially have anticipated? When you come up with the costs and benefits, think about the lifetime of the project. What are the costs and benefits likely to be over time? Step Two: Assign a Monetary Value to the Costs Costs include the costs of physical resources needed, as well as the cost of the human effort involved in all phases of a project. Costs are often relatively easy to estimate (compared with revenues). It's important that you think about as many related costs as you
  • 8. can. For example, what will any training cost? Will there be a decrease in productivity while people are learning a new system or technology, and how much will this cost? Remember to think about costs that will continue to be incurred once the project is finished. For example, consider whether you will need additional staff, if your team will need ongoing training, or if you'll have increased overheads. Step Three: Assign a Monetary Value to the Benefits This step is less straightforward than step two! Firstly, it's often very difficult to predict revenues accurately, especially for new products. Secondly, along with the financial benefits that you anticipate, there are often intangible, or soft, benefits that are important outcomes of the project. For instance, what is the impact on the environment, employee satisfaction, or health and safety? What is the monetary value of that impact? As an example, is preserving an ancient monument worth $500,000, or is it worth $5,000,000 because of its historical importance? Or, what is the value of stress-free travel to work in the morning? Here, it's important to consult with other stakeholders and decide how you'll value these intangible items. Step Four: Compare Costs and Benefits Finally, compare the value of your costs to the value of your benefits, and use this analysis to decide your course of action. To do this, calculate your total costs and your total benefits, and compare the two values to determine whether your benefits outweigh your costs. At this stage it's important to consider the payback time, to find out how long it will take for you to reach the break even point – the point in time at which the benefits have just repaid the costs. For simple examples, where the same benefits are received each period, you can calculate the payback period by dividing the projected total cost of the project by the projected total revenues: Total cost / total revenue (or benefits) = length of time (payback period).
  • 9. Example Custom Graphic Works has been operating for just over a year, and sales are exceeding targets. Currently, two designers are working full-time, and the owner is considering increasing capacity to meet demand. (This would involve leasing more space and hiring two new designers.) He decides to complete a Cost-Benefit Analysis to explore his choices. Assumptions · Currently, the owner of the company has more work than he can cope with, and he is outsourcing to other design firms at a cost of $50 an hour. The company outsources an average of 100 hours of work each month. · He estimates that revenue will increase by 50 percent with increased capacity. · Per-person production will increase by 10 percent with more working space. · The analysis horizon is one year: that is, he expects benefits to accrue within the year. Costs Category Details Cost in First Year Lease 750 square feet available next door at $18 per square foot $13,500 Leasehold improvements Knock out walls and reconfigure office space $15,000 Hire two more designers Salary, including benefits Recruitment costs Orientation and training $75,000
  • 10. $11,250 $3,000 Two additional workstations Furniture and hardware Software licenses $6,000 $1,000 Construction downtime Two weeks at approximately $7,500 revenue per week $15,000 Total $139,750 Benefits Benefit Benefit Within 12 Months 50 percent revenue increase $195,000 Paying in-house designers $15 an hour, versus $50 an hour outsourcing (100 hours per month, on average: savings equals $3,500 a month) $42,000 10 percent improved productivity per designer ($7,500 + $3,750 = $11,250 revenue per week with a 10 percent increase = $1,125/week) $58,500 Improved customer service and retention as a result of 100 percent in-house design $10,000 Total $305,500 He calculates the payback time as shown below: $139,750 / $305,500 = 0.46 of a year, or approximately 5.5 months. Inevitably, the estimates of the benefit are subjective, and there is a degree of uncertainty associated with the anticipated
  • 11. revenue increase. Despite this, the owner of Custom Graphic Works decides to go ahead with the expansion and hiring, given the extent to which the benefits outweigh the costs within the first year. Flaws of Cost-Benefit Analysis Cost-Benefit Analysis struggles as an approach where a project has cash flows that come in over a number of periods of time, particularly where returns vary from period to period. In these cases, use Net Present Value (NPV) and Internal Rate of Return (IRR) calculations together to evaluate the project, rather than using Cost-Benefit Analysis. (These also have the advantage of bringing "time value of money" into the calculation.) Also, the revenue that will be generated by a project can be very hard to predict, and the value that people place on intangible benefits can be very subjective. This can often make the assessment of possible revenues unreliable (this is a flaw in many approaches to financial evaluation). So, how realistic and objective are the benefit values used? Key Points Cost-benefit analysis is a relatively straightforward tool for deciding whether to pursue a project. To use the tool, first list all the anticipated costs associated with the project, and then estimate the benefits that you'll receive from it. Where benefits are received over time, work out the time it will take for the benefits to repay the costs. You can carry out an analysis using only financial costs and benefits. However, you may decide to include intangible items within the analysis. As you must estimate a value for these items, this inevitably brings more subjectivity into the process. Last Year BudgetCoppin State Regional Health CenterHealth Information Management Department BudgetSALARIES$471,040.00EDUCATION$1,200.00MAINTE NANCE
  • 12. CONTRACTS$25,000.00REPAIRS$3,500.00FOOD$300.00STO RAGE$7,200.00POSTAGE$1,200.00OFFICE SUPPLIES$36,000.00PROFESSIONAL DUES$250.00TRAVEL$1,800.00TOTAL$547,490.00AVERAG E HOURLY RATE$18.87REVENUE$78,000.00 Salaries BudgetPOSITIONSALARYHOURLY RATEYearlyDIRECTOR$80,000.00DRG COORDINATOR$28.00$58,240.00CODER$22.00$45,760.00CO DER$22.00$45,760.00CODER$18.00$37,440.00SUPERVISOR$ 20.00$41,600.00CLERK$12.00$24,960.00CLERK$12.00$24,96 0.00CLERK$12.00$24,960.00ROI CLERK$15.00$31,200.00ROI CLERK$15.00$31,200.00VITAL STATS CLERK$12.00$24,960.00$391,040.00DIRECTOR SALARY ADDED BACK IN$80,000.00TOTAL SALARIES FOR DEPARTMENT$471,040.00 Monthly ExpensesJANFEBMARAPRMAYJUNJULAUGSEPOCTNOVDE CYTDSALARIES$40,006.14$36,134.58$40,006.14$38,715.62$ 40,006.14$38,715.62$40,006.14$40,006.14$40,006.14$40,006.1 4$38,715.62$40,006.14$471,040.00EDUCATION$100.00$100.0 0$100.00$100.00$100.00$100.00$100.00$100.00$100.00$100.0 0$100.00$100.00$1,200.00MAINTENANCE CONTRACTS$2,083.33$2,083.33$2,083.33$2,083.33$2,083.33 $2,083.33$2,083.33$2,083.33$2,083.33$2,083.33$2,083.33$2,0 83.33$25,000.00REPAIRS$291.67$291.67$291.67$291.67$291. 67$291.67$291.67$291.67$291.67$291.67$291.67$291.67$3,50 0.00FOOD$25.00$25.00$25.00$25.00$25.00$25.00$25.00$25.0 0$25.00$25.00$25.00$25.00$300.00STORAGE$600.00$600.00$ 600.00$600.00$600.00$600.00$600.00$600.00$600.00$600.00$ 600.00$600.00$7,200.00POSTAGE$48.00$48.00$48.00$48.00$ 48.00$48.00$48.00$48.00$48.00$48.00$48.00$48.00$576.00OF FICE SUPPLIES$3,000.00$3,000.00$3,000.00$3,000.00$3,000.00$3,0 00.00$3,000.00$3,000.00$3,000.00$3,000.00$3,000.00$3,000.0 0$36,000.00*PROFESSIONAL DUES$20.83$20.83$20.83$20.83$20.83$20.83$20.83$20.83$20
  • 13. .83$20.83$20.83$20.83$250.00TRAVEL$150.00$150.00$150.0 0$150.00$150.00$150.00$150.00$150.00$150.00$150.00$150.0 0$150.00$1,800.00TOTAL$46,324.97$42,453.41$46,324.97$45, 034.45$46,324.97$45,034.45$46,324.97$46,324.97$46,324.97$ 46,324.97$45,034.45$46,324.97$548,156.52AVERAGE HOURLY RATEREVENUE$6,500.00$6,500.00$6,500.00$6,500.00$6,500. 00$6,500.00$6,500.00$6,500.00$6,500.00$6,500.00$6,500.00$6 ,500.00$78,000.00 Capstone Scenario- HIM 305 Coppin State Regional Health Center is a 270-bed, not-for- profit community hospital. Its largest percentage of patients consists of mothers and newborns, followed by a variety of cardiovascular-related admissions. It has an emergency department staffed by hospital employees. Coppin State Regional Health Center’s fiscal year follows the calendar year, ending December 31. In August, Coppin State Regional Health Center began its year-end budget process by establishing its financial assumptions for the following two years. Administration distributed operational and capital budget compilation packages to department managers for completion and return by September 30. Financial Assumptions: Coppin State Regional Health Center Administration assumed that revenue would remain constant, that it would continue its existing contracts with payers, that its Medicare population percentage would not change, and that no major infrastructure maintenance would be required in the upcoming fiscal year. · No major capital projects were anticipated. · In its operational budget, administration plans to include resources for a Joint Commission steering committee and related activities to prepare for the anticipated accreditation visit in the subsequent year. Coppin State Regional Health Center does not have a large
  • 14. marketing department. It has one marketing professional on staff whose responsibilities include the development and publishing of brochures and coordination of patient satisfaction surveys, which are compiled and analyzed by an outside vendor. In the past two years, there has been a slight, but continuing, decline in patient satisfaction among maternity patients. Suggestions for improvement have varied, but common complaints center on the lack of soothing ambiance in labor and delivery and the hospital policy prohibiting overnight visitors. The maternity and newborn departments have been very concerned about declining patient satisfaction. They are worried that the current year’s slight decline in maternity admissions is the result of that dissatisfaction and that patients are traveling a little further to give birth at a neighboring medical center, at which some of their physicians also have privileges. · The departments would like to renovate the maternity and newborn wing, forming a women’s center with increased emphasis on wellness and ancillary services. This would be a two-year capital project that would require marketing support and some minor disruption of services during construction. The cardiology department staff is very excited. They have just learned that a well-respected cardiologist has retired to the area and is exploring the idea of opening a small consulting practice. The cardiologist has not yet applied for privileges at any area hospitals, but it is known that she is used to working in a facility with its own cardiac catheterization lab. Because the current chief of the medical staff at Coppin State Regional Health Center is a personal friend of the cardiologist, the cardiology department believes that she could be lured on staff if the hospital had its own lab. · Based on the volume of patients that Coppin State Regional Health Center currently sends out to another facility for cardiac catheterization, the cardiology department believes that patient care would be facilitated by the expansion and that the increased revenue would help justify the cost.
  • 15. The HIM department has recently lost several employees to retirement and promotions with the facility. It is currently down two coders and a file clerk, and has reduced its weekend coverage to one person, day shift only. Transcription is handled largely by the department, with an outside service processing any overflow. · The HIM department would like to outsource all of its transcription and move to a Web-based coding system that would allow the coders to telecommute. · These changes would also require the implementation of an Electronic Record System (EHR). All three departments submitted capital budget requests for the projects described. Budget Considerations (to be submitted in a Word document with spreadsheets): 1. What things should be considered in conducting a cost- benefit analysis on each project? 2. At this point in your decision making which request is most appropriate? Request for Information, Request for Proposal or Request for a Quote? Explain your answer. Develop a request for proposal to send to the transcription and coding services. 3. If the hospital can only approve one of the proposed projects, which do you think has the best chance of being approved? Why? 4. If you were the director of the HIM department, how would you justify your department’s project so that it is presented most favorably? What are the benefits to selecting this project?