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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Cost of Capital and Capital Structure
Choosing between debt and equityCost of capital conceptsEstimating the cost of capital“Optimal” capital structure determination
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Cost of Capital Basics
Sources of organizational capitalDebt -- bonds, term loans, debenturesEquity -- retained earnings, stock
Capital structure defined -- “mix” of debt/equity capital utilized
Cost of capital definedDebt -- interest/coupon rateEquity -- dividends, opportunity costs
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
The corporate cost of capital is a blend (weighted average) of the costs of the financing components. (WACC)
WACC Equation: WACC = [(Wd)*(Kd)*(1-T)] + [(We)*(Ke)]
WACC assumption -- Optimal structure implied by weights (Wd, Kd)
Interpretation of WACC estimateUse of historical vs. marginal costs
Cost of Capital Basics
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Estimating the WACC:Cost of Debt (Kd)
Discuss current debt cost with banker:Investment banker if bonds are used.Commercial banker if loan is used.
Look at YTM on outstanding issues if actively traded (PV, maturity, coupon)
Look to the debt markets for guidance. Find the interest rate on recent issues:By companies with same debt rating.By companies that are similar (size, risk)
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Cost of Debt (Kd)
For a not-for-profit organization, the component cost of debt is the interest rate on a new issue.
An investor-owned organization must consider the tax benefits of debt:Assume that Valley Clinic (VC) has a 40% tax rate.
According to its bankers, a new bank loan would have an interest rate of 10%.
Its effective cost of debt (Kd) would be 10% x (1 - T) = 10% x 0.6 = 6.0%.
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Cost of Debt (Kd)
Not-for-profit organization KdTax exempt municipal bond financingKd comparisons with FP organizations
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Cost of Equity Capital (Ke)
The effective cost of debt (Kd) is the return required by debt suppliers, and the effective cost of equity (Ke) is defined similarly.
For investor-owned businesses the primary sources of equity are:Retained earnings. (Kre)New common stock sales. (Ks)
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
The cost of new common stock (Ks) is the rate of return that investors require on that stock.
The cost of retained earnings as an opportunity cost of capital:If earnings are retained rather than paid
out as dividends, the stockholders bear an opportunity loss.
These funds could be reinvested in alternative investments of similar risk.
Cost of Equity (Ke)
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Thus, retained earnings have roughly the same cost as does similar forms of common stock.
There are three primary methods used to estimate the component cost of equity in FP businesses:Capital Asset Pricing Model (CAPM)Discounted cash flow (DCF) modelDebt cost plus risk premium model
Cost of Equity (Ke)
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
CAPM Method (Ke estimation)
The Capital Asset Pricing Model (CAPM) is a equilibrium model that relates market risk to required rate of return.
The equation used is the Security Market Line (SML):
R(Ri) = RF + [R(RM) - RF] x bi.
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
CAPM Method (Cont.)
Input values to CAPM estimate“Risk free” rate (RF) estimation --
matching to avg. stock holding period Required market returns (R(Rm))
• Sources of data
• Choice of observation period(s)
Market beta value of stock• Definition/different types of betas
• Regression estimate
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Some Recent (1998) Beta Estimates
Alza Drug delivery systems 1.40 Baxter Medical Supplies 1.10 Beverly Enterprises Nursing homes 1.20 Glaxo Wellcome Diversified drugs 1.00 HEALTHSOUTH Rehabilitative care 1.35 Humana Managed care 1.55 Phycor Practice management 1.35 Tenet Healthcare Acute care hospitals 1.00 U.S. Surgical Medical Equipment 1.30 Valley Clinic (VC) Outpatient care 1.10
Source: Value Line
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
R(Ri) = RF + [R(RM) - RF ] x bi
= 8.5% + (13.5% - 8.5%) * 1.1 =14.0%.= Estimate of Ke for common stock(Limitations of CAPM estimates for Ke)
CAPM Method (Cont.)
What is Valley Clinic’s cost of equity (Ke) if RF = 8.5%, R(Rm) = 13.5%, and bi = 1.1?
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
DCF Method (Ke estimation)
The discounted cash flow (DCF) approach assumes that stock price is the present value of the expected dividend stream.
The DCF method can be used both with constant and nonconstant growth, but the calculations are more complicated when growth is nonconstant.
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
DCF Method (Cont.)
Under constant growth assumptions, the DCF model is as follows:
E(Ri) = R(Ri) = + E(g).E(D1)
P0
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
DCF Method (Cont.)
Where do we get the input values?P0 comes from the Wall Street Journal
(or many other sources).E(D1) can come from:
• Analyst’s estimates
• Historical growth rates
• Retention growth model estimates
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
DCF Method (Cont.)
Assume that P0 = $40, E(D1) = $2.72, and E(g) = a constant 7.0% for Valley Clinic. Then,
R(Ri) = + E(g) = + 7.0% E(D1)
P0
$2.72
$40
= 6.8% + 7.0% = 13.8%
= Ke estimate
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Equity Issuance Costs
Issuance costs on equity sales are larger than on debt sales.
Two methods are used to adjust the cost of equity for issuance costs:Adjust project cost (add-on cost)Adjust cost of equity, which produces two
costs: one for retained earnings and one for new stock sales.
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Debt cost plus risk premium method (Ke estimation)
Ke as a function of Kd and a stock’s risk premium (Ke = Kd + RPs)
RPs ranges from 4-7% above Kd based on historical data
Effect of interest rates on Kd and stock risk premiumsHigh interest rates -- low RPsLow interest rates -- high RPs
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Ke estimation methods (comparison)
When CAPM, DCF, & DCPRP estimates for the cost of equity (Ke) differ, judgment must be applied.
For our provider, the CAPM estimate is 14.0% and the DCF estimate is 13.8%.
A reasonable final estimate is 13.9%.
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Cost of retained earnings (Ke)
Opportunity cost to organizational shareholdersApplicable to FP and NFP organizationsConceptual challenge of Ke estimation (missing
market for retained earnings)
Approaches to estimating KeReplacement cost estimate (estimated growth in fixed
assets over time)Opportunity cost estimate (Ke for stock of similar
investment risk and size)
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Assume target weights of 35% debt and 65% equity. What is Valley Clinic’s
Weighted Avg. Cost of Capital?
WACC= [Wd x Kd x (1 - T)] + [We x Ke]
= (0.35 x 10% x 0.6) + (0.65 x 13.9%)
= (0.35 x 6.0%) + (0.65 x 13.9%)
= 2.1% + 9.0%
= 11.1%.
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Interpretation of WACC estimate
“True” opportunity cost of capitalNormative economic implications
“Hurdle” rate for proposed capital investments (minimum acceptable)
Technical issues with WACCDeviations from optimal structure -- effect on
WACCApplies only to average risk
assets/investments
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
What factors influence a company’s corporate cost of capital?
Market conditionsInterest rates (effect on Kd and Ke)Tax rates (effect on Kd)
Firm conditionsCapital structure policy Capital investment policy (business
risk, use of financial and operational leverage
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Risk and the Cost of Capital
Low
Cost ofCapital (%)
Corporate
RiskHighAverage
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
The Capital Structure Decision
The funds used to finance a business’ assets are called capital.
Capital structure is the financing mix on the right side of the balance sheet.
The capital structure decision revolves around this question: Is there an optimal mix of debt and equity
(as implied in WACC equation) that will maximize the value of the firm?
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Risk and Return Implications of Capital Structure Decisions
Consider a new for-profit ambulatory care clinic that needs $200,000 in assets to begin operations.
The business is expected to produce $50,000 in operating income.
It has two capital structure alternatives:No debt financing (all equity).$100,000 of 10% interest debt (50/50 mix).
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Pro Forma Balance Sheets
Stock Stock/Debt
Current assets $100,000 $100,000 Fixed assets 100,000 100,000
Total assets $200,000 $200,000
Bank loan (10% cost) $ 0 $100,000 Common stock 200,000 100,000
Total claims $200,000 $200,000
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Pro Forma Income Statements
Revenues $150,000 $150,000Operating costs 100,000 100,000 Operating income $ 50,000 $ 50,000Interest expense 0 10,000Taxable income $ 50,000 $ 40,000Taxes (40%) 20,000 16,000
Net income $ 30,000 $ 24,000
ROE 15% 24%
Total to investors $ 30,000 $ 34,000
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Conclusions
Debt financing levers up (increases) the rate of return (ROE) to owners. Thus, the use of debt financing is called financial leverage.
But, with uncertainty, the use of debt financing also increases owner’s risk.
Thus, the decision is not clear cut. The capital structure decision involves a classical risk/return trade-off.
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Business risk is the uncertainty inherent in a business’s operating income; that is, how well can managers predict operating income?
Business risk does not consider financing.
Business Risk
Probability
EBITE(EBIT)0
Low risk
High risk
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Factors that Influence Business Risk
Uncertainty about utilization rates
Uncertainty about reimbursement
Uncertainty about costs
Liability uncertainty
The degree of operating leverage (% of fixed to total costs) -- synergy with financial leverage
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Financial Risk
Financial risk is the additional risk placed on owners when debt financing is used (default risk)
The greater the proportion of debt financing, the greater the financial (default) risk
Diff. between ROE(U) and ROE(L)
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Capital Structure Theory
Capital structure theory attempts to define the relationship between debt financing and firm/equity value for investor-owned businesses.
Tradeoff models of capital structureDeveloped by Modigliani and MillerOrganizational “trade off” between costs
(increased risk) and benefits (increased returns) of debt capital
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Tradeoff Models of Capital Structure
VL = VU + (T x D) - PVDVL = equity value of unleveraged firmVU = equity value of leveraged firmT = firm’s marginal tax rateD = amount of debt capital usedPVD = PV of financial distress costs
Bimodal relationship between VL and level of debt capital utilized
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
%
15
D/A
Cost of Equity
Corporate Cost of Capital
Cost of Debt
$
D/A
Equity Value
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Tradeoff Theory Limitations
Minimal power to explain actual capital structure preferences of different firmse.g. emerging firm reliance on retained
earnings, mature firms reliance of debt, large differences in capital structure among similar industries/firms
Inconsistency of tax-related effects on capital structure decisions for investor-owned firms
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Asymmetric Information Model
Model assumptionsInformation asymmetry between
managers and investorsManagers exist to maximize equity value
Model predictions“Pecking order” of preferences for capitalDependent on magnitude of information
asymmetry present , perceived future growth prospects of the firm, presence of tangible vs. intangible assets
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Asymmetric Information Model
Emerging firmsLow level of tangible assets (equity)High growth prospects (equity/debt)Significant information asymmetry (debt)
Mature firmsHigh level of tangible assets (debt)Low growth prospects (debt/equity)Low information asymmetry (debt)High information asymmetry (equity)
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Summary Implications of Various Capital Structure Theories
Tax-related benefits of debt financing increase equity value of firm
Costs of financial distress (bankruptcy costs) variably offset the benefits of debt financing as debt level increases
Due to information asymmetries, firms will use variable amounts of debt vs. equity capital based on several factors.
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Implications of Capital Structure Theory
There is an optimal, or target, capital structure for every investor-owned business that balances the costs and benefits of debt financing.
Unfortunately, capital structure theory can not be used in practice to find a business’s optimal structure.
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Factors That Influence CapitalStructure Decisions In Practice
Organizational viability considerationOrganizational financial risk prefsLender/rating agency risk prefsLevel of reserve borrowing capacityIndustry benchmarks for riskShareholder control issuesOrganizational asset structureProjected growth rate/profitabilityOrganizational taxation issues
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Copyright © 1999 by the Foundation of the American College of Healthcare Executives
Not-For-Profit Businesses
The same general concepts apply to not-for-profit businesses:There is a benefit to debt financing (tax-
exempt bond financing)There also are costs
However, not-for-profit firms do not have the same financial flexibility as do investor-owned businesses.
Implications for capital structure