finance management

You are to evaluate a potential acquisition and make a recommendation. Download and read the scenario. Download and use the spreadsheet for analysis.

Save Time On Research and Writing
Hire a Pro to Write You a 100% Plagiarism-Free Paper.
Get My Paper

Present your analysis as a 3-page report in a Word document formatted in APA style.

Name your document LastnameFirstInitial_W3_A4 .For example, if your name is John Smith, your document will be named SmithJ_W3_A4 .

By Wednesday, October 2, 2013, submit your report to the W3: Assignment 4 Dropbox.

Assignment 4 Grading CriteriaMaximum PointsAnalyzed qualitative and quantitative information in the case study, applying correct reasoning.12Performed necessary calculations and presented results in appropriate formats.12Interpreted results of the qualitative and quantitative analysis.12Formulated and justified recommendations or conclusions based on the interpretation of results.20Presented case analysis expressing ideas clearly, using appropriate transitions and headings.12Applied the correct APA style, usage, grammar, and punctuation.4Total72  s

Save Time On Research and Writing
Hire a Pro to Write You a 100% Plagiarism-Free Paper.
Get My Paper

Merger Analysis

07

South University

(millions of $)

):

2007

%

$162.242

0.0%

$162.242

0.0%

$162.242

0.0% 2011

.000

0.0%

$162.242

$

0.0%

2007

$0.000

$0.000

2008 $0.000 $0.000

2009 $0.000 $0.000

$0.000

2010 $0.000 $0.000

$0.000

2011 $0.000 $0.000

$0.000

0.0%

0.0%

0.0

$0

0

Palmetto General Hospital

(Millions of Dollars)

2007 2008 2009 2010 2011
Inpatient revenue $110.384 $110.384 $110.384 $110.384 $110.384
Outpatient revenue 50.810 50.810 50.810 50.810 50.810
Gross patient revenue $161.194 $161.194 $161.194 $161.194 $161.194
Allowances and discounts 0.000 0.000 0.000 0.000 0.000
Net patient revenue $161.194 $161.194 $161.194 $161.194 $161.194
Other operating revenue 1.048 1.048 1.048 1.048 1.048
Total operating revenue $162.242 $162.242 $162.242 $162.242 $162.242
Patient services expenses $0.000 $0.000 $0.000 $0.000 $0.000
Interest expense 0.000 0.000 0.000 0.000 0.000
Total operating expense $0.000 $0.000 $0.000 $0.000 $0.000

$162.242 $162.242 $162.242 $162.242 $162.242

0.000 0.000 0.000 0.000 0.000

0.000 0.000 0.000 0.000 0.000

0.000

$162.242 $162.242 $162.242 $162.242 $0.000

EBITDA $162.242 $162.242 $162.242 $162.242 $0.000

$0.000

$0.000

$0.000

$0.000

Merger Analysis Case Study ©

2

0
Franklin Teaching Hospital
Enter appropriate input values in the cells colored red.
INPUT DATA: KEY OUTPUT:
(millions of $)
Cash flow data: Pro forma net cash flows:
Growth in gross revenues (

2007 2011 $162.242
Inpatient 0.0 2008
Outpatient 2009
Allowances and discount % 2010
Other op rev growth rate $0
Patient services exp as a
% of net patient rev 2007

EBITDA
Percent of net op CF Average 5-yr EBITDA 0.000
retained for growth
Annual inputs:
*Interest on **Cost Savings Acquisition value:
Year Required Loans at Franklin
$0.000 DCF method
Market multiple method:
Applied to 2000 EBITDA
Applied to avg EBITDA
Applied to discharges
Long-term (2008 and beyond)
constant growth rate
*Interest on required loans represents the
Market data: estimated interest payments on any borrowings
Discount rate (cost of equity) required to fund the acquisition.
EBITDA multiple
Market value to discharges ratio **Cost savings at Franklin represents any
synergistic benefits that will accrue at
Operating data: the acquirer as opposed to at the target.
Expected number of discharges
HISTORICAL DATA:
Palmetto General Hospital
Income Statements:
(Millions of Dollars)
2002 2003 2004 2005 2006
Inpatient revenue $81.624 $88.249 $99.010 $105.332 $110.384
Outpatient revenue 22.861 27.067 34.628 43.616 50.810
Gross patient revenue $104.485 $115.316 $133.638 $148.948 $161.194
Allowances and discounts 33.699 38.626 44.622 51.198 62.006
Net patient revenue $70.786 $76.690 $89.016 $97.750 $99.188
Other operating revenue 1.922 1.515 1.367 1.725 1.048
Total operating revenue $72.708 $78.205 $90.383 $99.475 $100.236
Patient services expenses $60.245 $73.858 $81.525 $90.645 $89.505
Interest expense 3.045 3.147 3.093 3.002 2.980
Depreciation 3.466 3.689 4.395 4.258 6.031
Total operating expense $66.756 $80.694 $89.013 $97.905 $98.516
Net income $5.952 ($2.489) $1.370 $1.570 $1.720
MODEL-GENERATED DATA:
Pro Forma Income Statements:
Net operating cash flow
Cost savings at University
Growth retentions
Terminal value
Net cash flow to equityholders
Valuation Results:
Average 5-year EBITDA
Value according to DCF method
Value according to market multiple method:
Applied to 2004 EBITDA
Applied to average 2004-2008 EBITDA

&A
Page &P

MHC6305 Financial Management of Healthcare Organizations

Merger Analysis Case Study

Franklin Teaching

Hospital

Currently, three hospitals serve the patient base of

Palmetto

County, Florida, which has a population of about 220,000. The hospitals include the following:

· Franklin Teaching Hospital, a

525

-bed, not-for-profit university-related teaching hospital

· Suncoast Regional Medical Center, a 200-bed, for-profit hospital owned by Senate Healthcare, a national chain

· Palmetto General, a

400

-bed, not-for-profit, acute care hospital owned by Citrus Healthcare

The service area has a total of 1,125 licensed beds for 200,000 people, or

5.1

beds per 1,000 people, which is higher than the national average of about 3.1 beds per 1,000 people, and much greater than 2 beds per 1,000 people needed under moderately aggressive utilization management. Of course, as a tertiary care facility, Franklin Teaching Hospital receives patients from throughout the state, but the bulk of its patients still come from the local five-county area.

With an excess capacity of hospital beds, the status quo may not survive the changing healthcare environment. Indeed, Palmetto General has had some tough years recently, as evidenced by its number of discharges, which have fallen to

11,412

in

2006

from 12,055 in

2005

and 12,824 in

2004

. Additionally, Senate Healthcare has been aggressive in building market share in other areas of Florida through acquisitions. As a result of these factors the local hospital market is likely to witness some consolidation, and the most likely result is the acquisition of Palmetto General by either Franklin Teaching Hospital or Senate Healthcare.

Palmetto General operated as a county hospital for over 50 years and consequently developed a reputation for providing healthcare services to the poor. After many years of operating losses, the county concluded that it could no longer afford to operate the hospital. So, in 1983, the county sold the hospital to Citrus Healthcare, a not-for-profit managed care organization and provider, which by 2006 had become the state’s largest integrated healthcare company.

Citrus Healthcare’s major business line is managed care. Its numerous plans, including HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), POS (Point of Service plans), Medicare, and Medicaid, serve over 400,000 members in 31 Florida counties, encompassing all of the major metropolitan areas. In addition to managed care plans, Citrus Healthcare owns nine different providers: two acute care hospitals including Palmetto General, two primary care hospitals, one rehabilitation hospital, one mental health facility, one hospice, one home healthcare provider, and one retirement facility.

Palmetto General is the flagship of Citrus Healthcare’s provider network and as such the company has maintained the hospital well in spite of falling inpatient utilization. In fact, in recent years, Palmetto General has built a new, state-of-the-art Heart Care Center and a modern Maternity Care Center. Furthermore, Palmetto General operates a full-service emergency department and a medical emergency helicopter service.

In response to the current situation, Franklin Teaching Hospital has formed a special committee to consider the feasibility of making an offer to Citrus Healthcare to acquire Palmetto General. The committee’s primary goals are as follows:

· To place a dollar value on Palmetto General’s equity (fund) capital, assuming that the hospital will be acquired and operated by Franklin Teaching Hospital

· To develop a financing plan for the acquisition

In addition, the committee has been asked to consider two other issues related to the potential acquisition.

· What is the best organizational structure for a combined enterprise? Currently, both Palmetto General and Franklin Teaching Hospital have separate boards of directors and management staffs. Of course, the senior members of the board of Palmetto General currently are Citrus Healthcare officers.

· Should the medical staffs of the two hospitals be integrated, and, if so, in what way? The medical staff of Palmetto General consists of local physicians, including many family practice physicians, while the medical staff at Franklin Teaching Hospital is almost entirely made up of specialists, and all are members of Franklin University’s College of Medicine with responsibilities that go well beyond clinical practice. A new committee will be formed to address the above issues should Franklin Teaching Hospital’s management agree to move forward with the acquisition offer, but some preliminary judgments are sought at this time.

As a starting point in the valuation analysis, the committee has obtained historical income statement and balance sheet data on both hospitals. Table 1 contains the data for Palmetto General, while Table 2 provides the data for Franklin Teaching Hospital. Note that both sets of statements focus on operating data, which are considered to be most relevant to the analysis. In addition, some relevant comparative data are presented in Table 3. Finally, relevant market data are contained in Table 4. (Note that the data in Tables 3 and 4 reflect late 2006 conditions.)

One of the toughest tasks that the committee faces is the development of Palmetto General’s pro forma cash flow statements, which form the basis of a discounted cash flow valuation. Two basic questions must be answered before any numbers can be generated. First, what synergies, if any, can be realized from the merger and how long will it take for any synergies to be realized? For example, can duplications be eliminated? Both hospitals have mercy flight helicopters and both offer full emergency department services, even though the two hospitals are less than two miles apart. And, what is the impact of such operational changes on revenues and costs and hence on the net cash flows that Palmetto General’s assets can produce? Second, once the consolidation takes place and all synergies have been realized, what is the long-term growth prospect for Palmetto General’s cash flows? The answers to these questions, and others, form the basis for the pro forma cash flow estimates.

Assume that you are the chair of the special committee formed at Franklin Teaching Hospital to evaluate the potential acquisition. You must present your findings and recommendations to the hospital’s board of directors. Note that Tables 1 through 4 contain far less data than normally available to parties involved in merger analyses, especially when the potential merger is friendly. In effect, the case discussion and accompanying data raise many more questions than they answer. You will be required to make a myriad of difficult assumptions to complete the analysis. Although you do not know much about Palmetto General’s local market, you do know the current trends in the health services industry. Use this knowledge to help make judgments about the case. The quality of many, if not most, real-world financial analyses depend more on the validity of the underlying assumptions than on the theoretical correctness of the analytical techniques.

Note: There is no preferred solution to this case, so your case analysis will be judged as much on the assumptions used in the analysis as on the analysis itself. Finally, remember that numerous risk analysis techniques are available that can be used to give decision makers some feel for the risks involved.

101.140

116.783

113.363

118.681

120.769

Table 1: Palmetto General Hospital: Historical Financial Statements (in millions of dollars)

2002

2003

2004 2005 2006

Income Statements

Inpatient revenue

81.624

88.249

99.010

105.332

110.384

Outpatient revenue

22.861

27.067

34.628

43.616

50.810

Gross patient revenue

104.485

115.316

133.638

148.948

16

1.1

94

Allowances and discounts

33.699

38.626

44.622

51.198

62.006

Net patient revenue

70.786

76.690

89.016

97.750

99.188

Other operating revenue

1.922

1.51

5

1.367

1.725

1.048

Total operating revenue

72.708

78.205

90.383

99.475

100.236

Patients services expenses

60.245

73.858

81.525

90.645

89.505

Interest expense

3.0

45

3.147

3.093

3.002

2.980

Depreciation

3.466

3.689

4.395

4.258

6.031

Total operating expense

66.756

80.694

89.013

9

7.9

05

98.516

Net income

5.952

2.489

1.370

1.570

1.720

Balance sheets

Cash and investments

2.388

1.538

0.162

0.185

0.198

Accounts receivable

18.860

20.581

20.821

21.570

16.732

Other current assets

4.5

39

8.475

4.669

2.585

2.898

Total current assets

25.787

30.594

25.652

24.340

19.828

Gross plant and equipment

102.596

116.694

122.611

133.499

14

6.1

30

Accumulated depreciation

27.243

30.505

34.900

39.158

45.189

Net plant and equipment

75.353

86.189

87.711

94.341

100.941

Total assets

101.140

116.783

113.363

118.681

120.769

Current liabilities

9.182

1

3.5

84

5.771

10.689

11.431

Long-term debt

33.572

47.302

50.325

49.155

48.781

Total liabilities

42.754

60.886

56.096

59.844

60.212

Fund balance

58.386

55.897

57.267

58.837

60.557

Total claims

2002

2003

2004

2005

2006

Income Statements

Inpatient revenue

Outpatient revenue

Gross patient revenue

Allowances and discounts

Net patient revenue

Other operating revenue

Total operating revenue

Patients services expenses

Interest expense

Depreciation

Total operating expense

Net income

Balance sheets

Cash and investments

Accounts receivable

Other current assets

Total current assets

Gross plant and equipment

Accumulated depreciation

Net plant and equipment

Total assets

Current liabilities

Long-term debt

Total liabilities

Fund balance

Total claims

369.594

374.111

390.525

401.249

422.450

Table 2: Franklin Teaching Hospital: Historical Financial Statements (in millions of dollars)

238.510

287.559

328.047

363.236

398.997

47.963

57.351

69.252

89.992

103.746

286.473

344.910

397.299

453.228

502.743

82.053

107.256

128.645

170.058

185.301

204.420

237.654

268.654

283.170

317.442

5.587

8.899

12.193

22.672

9.979

210.007

246.553

280.847

305.842

327.421

178.788

207.596

231.673

254.704

277.938

9.232

10.468

11.983

10.691

9.997

13.289

16.637

19.621

23.286

26.489

201.309

234.701

263.277

288.681

314.424

8.698

11.852

17.570

17.161

12.997

17.918

19.862

24.660

27.726

25.220

66.212

72.989

99.867

100.297

97.494

12.315

16.771

20.741

20.542

22.757

96.445

109.622

145.268

148.565

145.471

348.288

341.064

335.313

362.152

400.546

75.139

76.575

90.056

109.468

123.567

273.149

264.489

245.257

252.684

276.979

369.594

374.111

390.525

40

1.2

49

422.450

42.437

3

5.0

61

39.511

37.733

39.817

146.997

147.038

141.432

136.773

142.893

189.434

182.099

180.943

174.506

182.710

180.160

192.012

209.582

226.743

239.740

Table 3: Selected Comparative Data

Palmetto Franklin Teaching

Average age of plant

6.8 years

8.

5 years

Licensed beds

400 525

Occupancy rate

52.7%

64.2%

Average length of stay

5.5 days

6.6 days

Number of discharges

11,412

19,748

Medicare percent

57.2%

29.7%

Medicaid percent

10.3%

13.0%

Medicare case mix index

1.51

2.13

Gross price per discharge

$11,688

$20,204

Net price per discharge

$5,850

$12,757

Cost per discharge

$5,703

$12,144

Provident Healthcare

National Health Company

Provident Healthcare

National Health Company

Ratio of Total Equity Market Value to Number of Discharges

Table 4: U.S. Treasury Yield Curve

Maturity

Interest Rate

6 months

3.0

1 year

3.5
5 years

3.9

10 years

4.5

20 years

5.0

30 years

5.1

Market Risk Premium

Historical risk premium

7.0%

Average current risk premium as forecasted by three investment banking firms

6.0%

Market

Beta

s, Capitalization, and

Tax Rate

s of Two Publicly Traded Hospital Companies

Company

Beta

Debt/Asset Ratio

Tax Rate

Provident Healthcare

1.1

50%

40%

National Health Company

1.2

65%

43%

Ratio of Stock Price to EB1TDA per share

6.1
7.9

Ratio of Total Equity Market Value to Number of Discharges

$7000

$6000

Large hospital average

5.0%

Note: The data in this table reflect assumptions to ease the case analysis, as opposed to actual data.

Page 1 of 11

Week 3, Assignment 4

© 2007 South University

Still stressed from student homework?
Get quality assistance from academic writers!

Order your essay today and save 25% with the discount code LAVENDER