Question: INPUT DATA: Contractual Average allowances, Payer charge discounts, Payer mix per test bad debts Medicare 41% $900 40% Medicaid 17% $700 35% Blue Cross /

INPUT DATA: Contractual
Average allowances,
Payer charge discounts,
Payer mix per test bad debts
Medicare 41% $900 40%
Medicaid 17% $700 35%
Blue Cross / Private insurance 17% $1,000 50%
Managed care 14% $800 45%
Self-pay 5% $500 90%
Other 6% $800 30%
Total 100%
Equipment cost $300,000
Equipment installation $30,000
Year 1 number of tests per year 600
Years 2-5 test volume growth rate 10%
Net patient revenue inflation rate 10%
Tests per 1.0 nurse FTE 750
Annual nurse salary & benefits $100,000
Nurse salary & ben inflation rate 5%
Smith MOB Year 1-5 rent per year $39,000
Omega REIT Year 1-2 rent per year $36,000
Omega REIT Year 3-5 rent per year $42,000
Annual maintenance costs $50,000
Supplies cost per test $20
Maint & sup cost inflation rate 3%
Salvage value $100,000
Tax rate 21%
Pre-tax cost of capital 8%
Yr 1 Yr 2 Yr 3 Yr 4 Yr 5 Yr 6
MACRS recovery allowances 20% 32% 19% 12% 11% 6%
MODEL-GENERATED DATA:
Test volume:
0 1 2 3 4 5
Total number of tests per year 600 660 726 799 878
Net patient revenue:
Contractual Year 1
Year 1 allowances, net
number discounts patient
Payer of tests Charges bad debts revenue
Medicare $246 $221,400 $88,560 $132,840
Medicaid 102 $71,400 $24,990 $46,410
Blue Cross / Private insurance 102 $102,000 $51,000 $51,000
Managed care 84 $67,200 $30,240 $36,960
Self-pay 30 $15,000 $13,500.0 $1,500
Other 36 $28,800 $8,640 $20,160
Total 600 $505,800 $216,930 $288,870
0 1 2 3 4 5
Average net patient revenue per test $481 $491 $501 $511 $521
Net patient revenue $288,870 $294,647 $300,540 $306,551 $312,682
Nursing cost:
0 1 2 3 4 5
Nursing FTEs 1.0 1.0 1.0 2.0 2.0
Annual nurse salary & benefits $100,000 $105,000 $110,250 $115,763 $121,551
Nurse cost $100,000 $105,000 $110,250 $115,763 $121,551
Rent:
0 1 2 3 4 5
Smith MOB $39,000 $39,000 $39,000 $39,000 $39,000
Omega REIT $36,000 $36,000 $42,000 $42,000 $42,000
After-tax cost of capital 6.32%
PV cost of rent (Smith MOB) $162,862
PV cost of rent (Omega REIT) $164,438
Maintenance and supplies:
0 1 2 3 4 5
Maintenance $50,000 $51,500 $53,045 $54,545 $56,181
Supplies
Cost per test $20.00 $20.60 $21.22 $21.85 $22.51
Annual cost $12,000 $13,596 $15,404 $17,453 $19,774
Total maintenance and supplies $62,000 $65,096 $68,449 $71,998 $75,956
Net cash flows:
0 1 2 3 4 5
Equipment cost $300,000
Equipment installation 30,000
Net patient revenues $288,870 $294,647 $300,540 $306,551 $312,682
Nursing cost $100,000 $105,000 $110,250 $115,763 $121,551
Rent $39,000 $39,000 $39,000 $39,000 $39,000
$36,000 $36,000 $42,000 $42,000 $42,000
Maintenance and supplies 62,000 65,096 68,449 71,998 75,956
MACRS Depreciation 60,000 96,000 57,000 36,000 33,000
Operating income ($8,130) ($46,449) ($16,159) $1,791 $1,176
Taxes (1,707) (9,754) (3,393) 376 247
Net operating income ($6,423) ($36,694) ($12,766) $1,415 $929
MACRS Depreciation 60,000 96,000 57,000 36,000 33,000
Salvage value 100,000
Tax on salvage value (calculated below) 0
Net cash flow $330,000 $53,577 $59,306 $44,234 $37,415 $133,929

with information how to calculate the following:

Depreciable basis $0
Years 1-5 MACRS depreciation $0
Tax book value at end of year 5 $18,000
Salvage value at end of year 5 $0
Capital gain / (loss) $0
Tax on salvage value $0
Return on investment analysis:
After-tax cost of capital 6.32%
NPV $0
IRR 0.0%
MIRR 0.0%
Breakeven analysis:
Volume
NPV
Growth rate = 0% $0
Growth rate = 5% $0
Growth rate = 10% $0
Time (payback)
0 1 2 3 4 5
Annual cash flow $0 $0 $0 $0 $0 $0
Cumulative cash flow $0 $0 $0 $0 $0 $0
Payback 0.0 years
Abandonment value:
0 1 2 3 4 5
Net cash flow $0 $0 $0 $0 $0 $0
Net abandonment value $0 $0 $0 $0
NPV if abandoned $0 $0 $0 $0
After-tax cost of capital 0.00%

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