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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