Zimmer Biomet Holdings Budget Project Report

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Financial Statement Analysis

Zimmer Biomet Holdings has a cash ratio of 1.99. This means it can use its current assets to pay for its current liabilities. The company can thus be extended credit as it can use its current assets to pay about twice the value of its current liabilities (Delen, Kuzey & Uyar, 2015). The company had a cash ratio and quick ratio of 0.31 and 1.03, respectively. This shows that the company has a low liquidity level.

It had a 2.37% return on assets. It recorded a negative return on assets of 0.65%. Its return on equity was -1.10%. This can be attributed to the impact of the covid 19 pandemic, which resulted in lower sales. The pandemic also led to a contraction of its available cash flow from $ 1063 to $ 975. In the previous year, the company made a pretax profit, and thus its earnings per share were 9.60%. The sales of Zimmer Biomet Holdings are expected to increase, indicating a return on equity over the next 5 years. In 2019, the company has a high price-earnings ratio of 27.70 and a low price ratio of 18. This shows that the company will have higher profitability ratios in the future.

Despite the pandemic’s impact on profitability and sales, its net debt to capital was relatively moderate at 36.2%. This is a manageable debt-to-capital ratio as only a third of the company’s capital can be used to service the debt. This means that the company’s capital can be used to meet its debt obligations. Its debt leverage was 3.9 times.

The capital structure of Zimmer Biomet Holding is relatively stable. Its total debt to total equity is at 69.04%, while its total debt to total capital is at 40.84. Its long-term debt to equity and long-term debt total capital are at 64.33 and 38.05 respectively. The company has an interest coverage of 3.84. The capital structure and credit worthiness of the company are stable compared to its efficiency, liquidity, and profitability ratios.

The company has low financial efficiency ratios. Its total asset turnover is at 0.29, while its receivable turnover is at 4.99. Its turnover has been declining over the years showing that the company is not utilizing most of its assets to increase sales.

Zimmer Biomet Holdings has high profitability potential. Through the development of quality medical equipment and expansion of its market base, ensuring increased sales, it will be able to continually make profits. By ensuring that its manufacturing firms are meeting all the set standards and investing in new technology, it guarantees increased profitability too many of its rival firms in the next few years.

The major weakness in Zimmer Biomet Holdings is the unstable sales revenues. Even though it has implemented policies and is developing products to ensure its sales are higher, lower sales are negatively impacting its profitability. Over the next years, it is also expected to be underperforming compared to its competitors in the industry. This translates to lower profits, dividends payouts, and earnings per share to the company’s shareholders compared to its rival firms.

The average amount that can be extended to Zimmer Biomet holdings is $ 5103 million. This will maintain its debt to capital ratio at 50%, which is relatively manageable. This money can be channeled into the research and development of new medical equipment to ensure increased sales. This will also improve its competitiveness in the industry as well as ensure the company has flexible cash flow.

Budget Analysis

Table 1: Budget Estimates for Alpha and Beta PCS Centers

Proposed Operational Budget for 2018AlphaBeta
Patient Revenue12000001224000
Deductions11831480455
Net revenue1324543900689
Expenses
Salaries and wages703095478105
Staff benefits253113172117
Administrative expenses127988702
Advertising12141786
Collection fees1071729
Consultants22321518
Computer support2023813762
Equipment leases24401660
Insurance1672611374
Laboratory2940019600
Laundry and housekeeping80365464
Legal/audit50303420
Medical supplies3854226208
Printing and postage654784452
Professional fees1680011200
Rent4672631774
Repairs20831417
Telephone65484452
Utilities114297771
Depreciation4345229548
Bad debt expenses61904210
Total expenses1233917839063
Income (loss) before taxes9062661626
Taxes3625024650.
Income (loss) after taxes5437536975

The table below shows the budget estimates for beta and alpha PCS centers. Laboratory and professional expenses have been allocated on a ratio of 6:4 for alpha and beta centers respectively. This is because the alpha center has about 376 occupational health visits compared to 246 occupational health visits in the beta center in a week. The other expenses have been allocated based on estimated visits to each center. The alpha center is estimated to have 7500 annual visits which exceeds the annual visits in the beta health center by 2400. Therefore, the alpha center will be more profitable than the beta center. The alpha center is estimated to make a profit of $ 54,375 while the beta center is estimated to make a profit of $ 36975.

Due to a large number of estimated visits, the alpha center will also incur more administrative, laundry and cleaning, administrative expenses, and salaries compared to the beta center. The beta center will however incur increased advertising costs compared to the alpha center to increase the number of its annual visits.

The variable expenses include advertising, laboratory services, staff benefits, computer support, insurance, legal/audit, professional services, depreciation, and bad debts. Fixed expenses include salaries, administrative expenses, collection fees, consultants, laundry and housekeeping, medical supplies, printing and postage, telephone, and utilities.

The centers have the potential to record a higher number of visits compared to the estimated visits per center. This will cause the revenues from patients to increase and the profits per center in 2018 are likely to be higher.

Monthly Cash Budget

Table 2: Monthly budget estimates for Jasper Gardens Nursing Home

monthly budget
Skilled care
Medicare Part A344,611
Commercial17,949
Medicaid318,031
Self-pay145,441
VA8,108
Private insurance11,608
Total room and board845,747
Ancillary revenue
Medicare Parts A and B69,524
Commercial4,525
Medicaid1,531
Total ancillary revenue75,580
Total other revenue2,058
Total revenue923,384
Total expenses631,750
Total net revenue636,324
Pretax profit (loss)4,574
All taxes1,601
Profit (loss) after taxes2,973

The table below shows the estimated cash inflows.

Table 3: Cash inflows based on the aging analysis

Days30 or less31–6061–9091–120121–150
Medicare207067.582827124240.5165654207067.5
Medicaid079,890.579,890.579,890.579,890.5
Commercial
Insurance1262701262701262702247.43371.1
Private Insurance3482.43482.43482.41160.814544.7
Self-Pay58176.443634.129,089.420010
VA20271216810.83243.2405

This shows that during the first month, its cash inflows will be limited since the majority of its revenues are generated from Medicare and Medicaid which make payment after 30 days. This will hurt the operating cash available over the months. Thus to be able to meet its operating expenses the Nursing home will need to cut in its recurrent expenditures so that it matches the amount of cash available for operation.

Within 30 days of payment, Jasper Garden Nursing can only be able to meet 62% of its monthly expenditure. Thus 38% of monthly expenditures are carried forward to the next months. This increases the non-current liabilities of the nursing home in the long run.

From Table 3 above, the Jasper Gardens Nursing home should try to self-pay to ensure the availability of enough funds. The implication of the aging analysis is that reduces the cash flexibility of the Nursing Home thus limiting its operations.

Webster Hospital—Long-Term Debt Financial Analysis

Table 4: Webster Hospital Debt Analysis

Bond Grade

Days Cash on Hand

Webster Hospital

8234

Days in Accounts Receivables90
Days in Current Liabilities218
Cash to Debt (%)30%
Total Margin-%6
Salaries and benefit costs as % of total revenue

Rrrrrrreererevenue

54.33
Average Age of Plant (years)12.65
Capital Expenditures as % of Depreciation Expense53.06

The debt to asset ratio of the Webster Hospital in 2007 before the acquisition of a long-term was at 36.54%. The hospital would require additional funding of $ 2,822,978 to finance new construction, renovations, and the acquisition of technology. Table 3 shows Webster’s debt analysis to determine the type of bond it can use to finance the debt. From the table, Webster Hospital bonds are likely to be rated high grade. This is because they meet most of the requirements of AA bonds compared to BBB bonds.

From Table 4, Webster Hospital has 90 days in account receivable and 218 days in current liabilities. It has low cash-to-debt ratio of 0.3%. The hospital has a longer average age of plants at 12.65 years.

The principal amount for the bonds is $ 2,822,978. The Webster Hospital will incur interest of $ 335,031 annually over 10 years. This is equivalent to 0.3% of its current annual expenses. The additional debt for capital expenditure will improve the hospitals and thus increase their revenue. Thus, Webster Hospital will incur lower borrowing costs by the use of high-rated bonds to finance its expenditure.

Surgery for Middleboro

Starting an ambulatory surgery in Jasper will increase the non-current liabilities of the Middlesboro Community hospital by $ 450,000. After 5 years, the Middlesboro Community Hospital will be expected to incur a capital expenditure to purchase new surgery equipment. The surgery equipment is estimated to have an equipment life of 7.5 years. The surgery equipment has an annual depreciation expense of $ 60,000. After 7.5 years, Middlesboro Community Hospital will need to purchase new equipment, thus increasing its expenditure and thus reducing its net profit.

Table 5: Estimated Profits of Ambulatory Surgery

R-E
Year 0120,000
Year 0240,000
Year 0360,000
Year 04100,000
Year 05140,000
Year 06190,000
Year 07240,000
Year 08300,000

The profits of ambulatory surgery have been increasing at decreasing rate over 5 years. The increase in profits has gradually declined from 50% to 40% over the 5 years. Ambulatory surgery has the potential to continue making profits in future years. The capital expenditures incurred can be reduced by ensuring maintenance and purchase of quality surgery equipment. Following the profits trend, the ambulatory surgery wing is estimated to make a profit of $ 300,000 at the end of the 8 years in operation.

Hospital Discounts

About 55.1% of all residents in Hillsboro County are dependent on employer-based health insurance coverage. This means that majority of patients’ revenue for the Middleboro and Webster Hospitals is paid by employer-based insurance covers. A demand for an additional 10% discount on all employees admitted would cut the revenue of these hospitals. To avoid losing most of their patients to another cheaper hospital, MCH and WC could implement a discount depending on the number of days the employees are admitted. The additional discount can be implemented if the employer-based health insurance cover will cover the health expenses within two weeks of discharge. This will aid in reducing account receivables for these accounts. Timely insurance payments will enable the hospitals to meet their monthly expenses and thus ensure quality service delivery. The hospitals should also consider implementing the policy for employees who do not require expensive and specialized care.

Implementation of the 10% discount will reduce medical expenses for employers. This, in turn, can attract other employers to implement health insurance covers that favor the Middlesboro Community Hospital and the Webster Hospital. The discount offer can also be extended to other insurance covers based on payment, the number of days the patient is admitted as well as the level of specialized care offered to the patients.

The hospitals may practice price discrimination in pricing their services. This will ensure that even though its income from one employer-based insurance scheme has declined, there is a way to ensure the hospital does not incur extra expenses. The question of pricing may arise among people using the same health care scheme compared to those using different health care insurance covers.

Discounts not only encourage early payment but can be used to negotiate with employers to ensure that the number of patient revenue increases. The Middlesboro Community Hospital and the Webster Community hospital can use the demand for additional funding to ensure that majority of the employees will seek healthcare services from the hospitals. Thus, the employers will be expected to ensure that most of their employees seek healthcare services from the Middlesboro Community and Webster Hospitals to ensure they enjoy discounts on the number of employees who seek healthcare services from these hospitals. This might encourage other employers in the area to use these hospitals due to the discounts they enjoy. This discount can also be extended to other individuals to ensure we gain customer loyalty from our patients, thus increasing revenues from the patients. Thus, the hospitals are less likely to suffer a decline in revenue if they use access to discounts in their favor.

Medicaid Expansion

Medic aid provides health insurance coverage to approximately 4.9% of the population of Hillsboro County. The rejection of Federal funding for medical aid will reduce the insurance cover for low-income household who were entirely dependent on Medicaid insurance cover. This will have an effect on increasing account receivables for the Middleboro Community Hospital and the Webster Hospital. Limited health insurance coverage will increase out-of-pocket payments. An increase in account receivables of the two hospitals will increase expenses for account receivables thus reducing the incomes of the hospitals in the long run. The hospitals may then be forced to implement strict policies to ensure that account receivables do not increase such as requiring payment before service delivery for patients without health insurance coverage. This may also affect the number of patients served by the hospital negatively. In the low-income part of the state, the low-income household may forfeit seeking healthcare services due to the high costs.

However, in high-income areas, rejection of expansion of federal funding of medic aid will have a low impact on the performance of the health centers. This is because most of the population can afford private health insurance coverage or enjoy employer-based health insurance. Thus, a lack of Medicaid will not limit their health care access. In this region, account receivables are most likely to be very low thus the hospitals will not incur any expenses in allowance for account receivables.

New Primary Care Practices in Jasper

The table below shows the budget estimates for establishing two new primary practices in Jasper. The hospitals will hold a capacity of 300 and 500 patients respectively. The Alpha Center will lease a building whereas the beta center will purchase an existing building and renovate it to fit its requirement.

Table 6: Budget estimates for Beta and Alpha Centers

Alpha CenterBeta Center
Leasing and renovation costs200,0001,000,000
Equipment800,000900,000
Furniture and fittings500,000500,000
Medical supplies1,200,0001,500,000
Recruitment cost200,000150,000
Legal costs100,00070,000
Research and training500,000600,000
Salaries1,500,0001,200,000
Recurrent expenditure800,000400,000
Advertising expenditure200,000150,000
Branding expenditure50,00040,000

Due to financial constraints, leasing would be the best option while establishing the hospitals in the short run. This will ensure there is the availability of funds to finance other activities in these health centers. Maintenance and safety measures are incurred by the owner thus reducing expenditures of the hospital. The hospitals will also enjoy the tax benefits of leasing over purchasing new buildings.

The disadvantage of leasing is that all the improvement and renovation incurred will move to the owner of the building once the lease is over. The hospital may be limited on how to renovate and make changes to the building depending on the term and conditions of the lease. While in purchasing a building the hospital could make an income by leasing the empty spaces, leasing cannot generate these incomes. A lease limits the hospital on the immediate occupants of the building whereas by owning the building, the patient can control who lets the extra spaces.

In the long run, the beta center will enjoy tax deductions as it’s their building. The Alpha Center will incur increased fixed costs at the end of the lease period. This is because they will incur renovation and improvement costs in the next building they will lease. This will also lead to increased advertising, as well as branding costs.

Reference

Delen, D., Kuzey, C., & Uyar, A. (2015). Measuring firm performance using financial ratios: A decision tree approach. Expert systems with applications, 40(10), 3970-3983.

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