Chapter 9 Cost Analysis and Estimation Questions Answers
Chapter 9 Cost Analysis and Estimation Questions Answers
Q9.1 The relevant cost for most managerial decisions is the current cost of an input. The
relevant cost for computing income for taxes and stockholder reporting is the
historical cost. What advantages or disadvantages do you see in using current costs
for tax and stockholder reporting purposes?
Q9.1 ANSWER
Theoretically, it would be preferable to use current costs for income tax calculations
and stockholder reporting. On a practical level, however, this would be nearly
impossible. Estimation of current cost, based upon current market values, would be
a difficult task with a great deal of room for subjectivity. This could result in many
arbitrary cost designations, and the "policing" of tax returns would become a much
more formidable task. On a practical basis, the use of historical costs for tax and
stockholder reporting purposes has obvious advantages over the theoretically
superior current costs.
Q9.2 Assume that two years ago, you purchased a new Jeep Wrangler SE 4WD with a soft
top for $16,500 using five-year interest-free financing. Today, the remaining loan
balance is $9,900 and your Jeep has a trade-in value of $9,500. What is your
opportunity cost of continuing to drive the Jeep? Discuss the financing risk exposure
of the lender.
Q9.2 ANSWER
$9,500. If you sell the Jeep, $9,500 can be generated to pay down your remaining
loan balance. It is the current cost or replacement value of your current vehicle. It is
the relevant economic cost of continuing to drive the Jeep. Historical cost of
$16,500, and the remaining loan balance of $9,900 are irrelevant for decision-making
purposes. With a current market value of only $9,500 against a remaining loan
balance of $9,900, the lender faces the risk of borrower default. Aggressive interest-
free financing offered by the major automakers since the late-1990s has the potential
to create big debt collection problems in the future.
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Q9.3 Southwest Airlines offers four flights per weekday from Cleveland, Ohio to Tucson,
Arizona. Adding a fifth flight per weekday would cost $15,000 per flight, or $110
per available seat. Calculate the incremental costs borne by Southwest following a
decision to go ahead with a fifth flight per day for a minimal 60-flight trial period.
What is the marginal cost? In this case, is incremental cost or marginal cost
relevant for decision making purposes?
Q9.3 ANSWER
Marginal costs are the cost effect of one-unit changes in output. Incremental cost is
the cost effect associated with a given managerial decision. Incremental costs may
also relate to output changes, but the output change involved is that of a relevant
block or increment of service. In this instance, the incremental cost associated with a
decision to go ahead with a fifth flight per day for a minimal 60-flight trial period is
$900,000 (= $15,000 60). The marginal cost per passenger is only $110. In this
case, the incremental cost of $900,000 is the relevant cost for decision making
purposes. With expected revenues in excess of $900,000, Southwest should go
ahead with the planned expansion.
Q9.4 The Big Enchilada restaurant has been offered a binding one-year lease agreement
on an attractive site for $1,800 per month. Before the lease agreement has been
signed, what is the incremental cost per month of site rental? After the lease
agreement has been signed, what is the incremental cost per month of site rental?
Explain.
Q9.4 ANSWER
Any cost that is invariant across decision alternatives is a sunk cost. Sunk costs are
irrelevant for current decision-making purposes and should not enter into decision
analysis. Before the lease agreement has been signed, all costs are variable, and the
incremental cost per month of site rental is $1,800 per month. After the lease
agreement has been signed, lease costs are sunk, and the incremental cost per month
of site rental is $0.
Q9.5 What is the relation between production functions and cost functions? Be sure to
include in your discussion the effect of competitive conditions in input factor markets.
Q9.5 ANSWER
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Cost Analysis and Estimation
There is a direct relation between production and cost functions. A cost function is
determined by combining a given production function with the related price
functions for the inputs actually employed in production. If inputs are purchased in
competitive markets so that their prices are constant irrespective of how many are
purchased, the relation between production and cost functions is straightforward (see
Figures 9.2, 9.3, and 9.4). With imperfect competition in input markets, the relation
becomes somewhat more complex. In all cases, cost/production relations can be
employed either to minimize total costs subject to an output constraint or to
maximize output subject to a total cost or budget constraint.
Q9.6 The definition of output elasticity is εQ = Q/Q X/X (X represents all inputs),
whereas the definition of cost elasticity is εC = C/C Q/Q. Explain why εQ > 1
indicates increasing returns to scale, where εC < 1 indicates economies of scale.
Q9.6 ANSWER
If Then Implies
εQ > 1 Q/Q > Rising Q/X ratio, falling AC.
X/X
εC < 1 C/C < Falling C/Q ratio, falling AC.
Q/Q
This means that εQ > 1 and εC < 1 are both consistent with falling average costs.
Q9.7 The president of a small firm has been complaining to the controller about rising
labor and material costs. However, the controller notes that average costs have not
increased during the past year. Is this possible?
Q9.7 ANSWER
Yes, the phenomenon of constant (or even decreasing) average costs coupled with
increasing input prices is quite feasible. It stems from an increase in input
productivity that could result from any number of causes. One obvious possibility
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Chapter 9
Q8.8 With traditional medical insurance plans, workers pay a premium that is taken out of
each paycheck and must meet an annual deductible of a few hundred dollars. After
that, insurance picks up most of their health-care costs. Companies complain that
this gives workers little incentive to help control medical insurance costs, and those
costs are spinning out of control. Can you suggest ways of giving workers better
incentives to control employer medical insurance costs?
Q8.8 ANSWER
In hopes of slowing the growth in medical costs, some companies are moving
towards Aconsumer driven@ medical coverage that gives employees a financial
stake in what they pay for medical care. Such plans feature high deductibles of as
much as
$500 per year for prescriptions and $1,000 per year for all other medical costs. To
help pay these costs, some companies deposit $300 to $1,800 per year in an
Aemployee benefits account.@ At some firms, like Whole Foods Market, Inc.,
medical claims fell 13% in the first year such a plan was adopted, and about 90% of
employees had money left over to use next year.
The Whole Foods plan, which workers themselves chose over two competing
plans after a series of votes last summer, has no premiums at all for many workers.
But the deductible is a relatively hefty $1,500. Whole Foods each year puts money
into an account for each worker to use for health-care expenses. If employees don't
spend their money in one year, they get to carry it over to future years. After the
deductible is reached, the plan operates more like a traditional one, picking up 80%
of most medical expenses. The hope is that once the money feels as though it
belongs to them, people won't get an MRI when an X-ray (or an ice pack) might do.
Already at Whole Foods, the plan is inducing the company's butchers, bakers and
baggers to take responsibility for cutting costs by buying generic drugs, asking for
fee waivers on lab tests and other procedures, and keeping a closer eye on what
doctors charge for their services.
The plans have one big drawback: People with chronic conditions can take a
big hit, since they have little choice about how often they go to the doctor. Some
critics fear that the plans will discourage people from getting the care they need.
(See: Ron Lieber, ANew Way to Curb Medical Costs: Make Employees Feel the
Sting,@
Q9.9 The Wall
Will firms Street Journal
in industries Online,
in which highJune 23, of
levels 2004. (http://online.wsj.com)
output are necessary for minimum
efficient scale tend to have substantial degrees of operating leverage?
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Cost Analysis and Estimation
Q9.9 ANSWER
Yes, in industries where the minimum efficient scale is large, long-run average costs
tend to decrease rapidly as output increases. Fixed costs tend to be a substantial
share of total costs. When fixed costs are large, the degree of operating leverage also
tends to be high, and firms with high levels of output necessary for minimum
efficient scale will tend to have a substantial degree of operating leverage.
Q9.10 Do operating strategies of average cost minimization and profit maximization always
lead to identical levels of output?
Q9.10 ANSWER
No, operating strategies of average cost minimization and profit maximization lead
to identical rates of input combination, but do not typically lead to identical levels of
total output. Average cost minimization is an appropriate strategy when managers
wish to produce a target level of output in an optimal or least-cost fashion. On the
other hand, profit maximization implies production of an optimal level of output, as
revealed by product demand, in an optimal or least-cost fashion.
ST9.1 Learning Curves. Modern Merchandise, Inc., makes and markets do-it-yourself
hardware, housewares, and industrial products. The company's new Aperture
Miniblind is winning customers by virtue of its high quality and quick order
turnaround time. The product also benefits because its price point bridges the gap
between ready-made vinyl blinds and their high-priced custom counterpart. In
addition, the company's expanding product line is sure to benefit from cross-selling
across different lines. Given the success of the Aperture Miniblind product, Modern
Merchandise plans to open a new production facility near Beaufort, South Carolina.
Based on information provided by its chief financial officer, the company estimates
fixed costs for this product of $50,000 per year and average variable costs of:
A. Estimate total cost and average total cost for the projected first-year volume of
20,000 units.
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Chapter 9
ST9.1 SOLUTION
A. The total variable cost function for the first year is:
TVC = AVC Q
= ($0.5 + $0.0025Q)Q
= $0.5Q + $0.0025Q2
TC = TFC + TVC
= $50,000 + $0.5Q + $0.0025Q2
= $1,060,000
AC = TC/Q
= $1,060,000/20,000
B. If actual total costs were $848,000 at a volume of 20,000 units, actual average total
costs were:
AC = TC/Q
=
$848,000/20,000
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Cost Analysis and Estimation
= $42.40 - $53
Alternatively,
AC
Learning rate = 1 AC21 x 100
-
= 20%
ST9.2 Minimum Efficient Scale Estimation. Kanata Corporation is a leading
manufacturer of telecommunications equipment based in Ontario, Canada. Its main
product is micro-processor controlled telephone switching equipment, called
automatic private branch exchanges (PABXs), capable of handling 8 to 3,000
telephone extensions. Severe price cutting throughout the PABX industry continues
to put pressure on sales and margins. To better compete against increasingly
aggressive rivals, the company is contemplating the construction of a new
production facility capable of producing 1.5 million units per year. Kanata's in-
house engineering estimate of the total cost function for the new facility is:
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Chapter 9
B. In light of current PABX demand of 30 million units per year, how would you
evaluate the future potential for competition in the industry?
ST9.2 SOLUTION
A. Minimum efficient scale is reached when average costs are first minimized. This
occurs at the point where MC = AC.
$3, 000
= Q + $1,000 + $0.003Q
Therefore,
MC
= AC
$1,000 + $0.006Q = $3, 000 + $1,000 + $0.003Q
Q
3, 000
0.003Q =
Q
3, 000
= 0.003
Q2
Q2 = 1,000,000
Q = 1,000(000) or 1 million
Alternatively, MES can be calculated using the point cost elasticity formula, since
MES is reached when εC = 1.
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Cost Analysis and Estimation
εC TC Q
= Q x TC
0.003Q2 = 3,000
Q2 = 1,000,000
= 1,000(000) or 1 million
QMES
B. With a minimum efficient scale of 1 million units and total industry sales of 30
million units, up to 30 efficiently sized competitors are possible in Kanata's market.
Market Size
Potential Number of Efficient Competitors =
MES Size
30, 000,
=
000
1, 000,
000
= 30
Thus, there is the potential for N = 30 efficiently sized competitors and, therefore,
vigorous competition in Kanata's industry.
P9.1 Cost Relations. Determine whether each of the following is true or false. Explain
why.
A. Average cost equals marginal cost at the minimum efficient scale of plant.
B. When total fixed cost and price are held constant, an increase in average
variable cost will typically cause a reduction in the breakeven activity level.
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Chapter 9
D. When long-run average cost is decreasing, it can pay to operate larger plants
with some excess capacity rather than smaller plants at their peak efficiency.
P9.1 SOLUTION
A. True. The point of minimum average cost identifies the minimum efficient scale of
plant. By definition, average and marginal costs are equal at this point.
C. True. When εC > 1, the percentage change in cost exceeds a given percentage change
in output. This describes a situation of increasing average costs and diseconomies of
scale.
D. True. When long-run average costs are declining, it can pay to operate larger plants
with some excess capacity rather than smaller plants at their peak efficiency.
E. False. The degree of operating leverage is defined DOL = Q(P - AVC)/(Q(P - AVC)
- TFC). Therefore, when total fixed costs are zero, DOL is a constant and an
increase in average variable cost will have no effect on DOL.
P9.2 Cost Curves. Indicate whether each of the following involves an upward or
downward shift in the long-run average cost curve or, instead, involves a leftward or
rightward movement along a given curve. Also indicate whether each will have an
increasing, decreasing, or uncertain effect on the level of average cost.
A. A rise in wage rates.
B. A decline in output.
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Cost Analysis and Estimation
P9.2 SOLUTION
A. A rise in wage rates will cause an upward shift in the LRAC curve and increase
LRAC.
C. Energy-saving technical change will cause a downward shift in the LRAC curve and
decrease LRAC.
D. A fall in interest rates gives rise to a downward shift in the LRAC curve and a
decrease in LRAC.
E. Learning, like any beneficial technical change or innovation, will cause a downward
shift in the LRAC curve and decrease LRAC.
P9.3 Incremental Cost. South Park Software, Inc. produces innovative interior
decorating software that it sells to design studios, home furnishing stores, and so on.
The yearly volume of output is 15,000 units. Selling price and costs per unit are as
follows:
Management is evaluating the possibility of using the Internet to sell its software
directly to consumers at a price of $300 per unit. Although no added capital
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Chapter 9
Calculate the incremental profit that South Park would earn by customizing its
instruments and marketing them directly to end users.
P9.3 SOLUTION
This problem should be answered by using incremental profit analysis. The analysis
deals only with the incremental revenues and costs associated with the decision to
engage in further processing.
Since the incremental profit is positive, the decision to engage in further processing
would be more profitable than continuing the present operating policy.
P9.4 Accounting and Economic Costs. Three graduate business students are considering
operating a fruit smoothie stand in the Harbor Springs, Michigan, resort area during
their summer break. This is an alternative to summer employment with a local firm,
where they would each earn $6,000 over the three-month summer period. A fully
equipped facility can be leased at a cost of $8,000 for the summer. Additional
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Cost Analysis and Estimation
projected costs are $1,000 for insurance and $3.20 per unit for materials and
supplies. Their fruit smoothies would be priced at $5 per unit.
C. What is the economic breakeven number of units for this operation? (Assume a
$5 price and ignore interest costs associated with the timing of lease payments.)
P9.4 SOLUTION
Total Fixed
Variable
Accounting = TCA = leasing plus + materials plus
Cost insurance costs
supplies costs
= $8, 000 + $1, 000
+ $3.2 Q
B. The economic cost function is:
= $9, 000 + $3.2 Q
Total Economic Summer employment
Cost = + TC A
opportunity cost
= 3($6, 000) + $9, 000 + $3.2
Q
C.
= $27, 000 + $3.2 Q
The economic breakeven
TFC
point Q
isBEreached when:
= P - AVC
$27, 000
=
$5000
= 15, - $3.20
units
P9.5 Profit Contribution. Angelica Pickles is manager of a Quick Copy franchise in
White Plains, New York. Pickles projects that by reducing copy charges from 54 to
44 each, Quick Copy's $600-per-week profit contribution will increase by one-third.
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Chapter 9
A. If average variable costs are 24 per copy, calculate Quick Copy's projected
increase in volume.
B. What is Pickles' estimate of the arc price elasticity of demand for copies?
P9.5 SOLUTION
A. The initial, or before-price reduction, copy volume can be calculated using the profit
contribution formula.
$600 =
($0.05 - $0.02)Q1 Q
= 20,000
After the price reduction, a profit contribution of $800 (=1.33 600) requires an
output level of 40,000 units since:
Q2 = 40,000
= 40,000 - 20,000
B. Given the large magnitude of this price reduction, use of the arc price elasticity
formula is appropriate.
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Cost Analysis and Estimation
P 2 + P1
= Q2 - Q 1 x
EP
P2 - P1 Q2 + Q 1
40, 000 - 20, 000 $0.04 + $0.05
= x
$0.04 - $0.05 40, 000 +
20, 000
P9.6 Cost-Volume-Profit Analysis. =Textbook
- 3 (Elastic)
publishers evaluate market size, the degree
of competition, expected revenues, and costs for each prospective new title. With
these data in mind, they estimate the probability that a given book will reach or
exceed the breakeven point. If the publisher estimates that a book will not exceed the
breakeven point based upon standard assumptions, they may consider cutting
production costs by reducing the number of illustrations, doing only light copy
editing, using a lower grade of paper, or negotiating with the author to reduce the
royalty rate. To illustrate the process, consider the following data:
Variable Costs
Printing, binding and paper $22.50
Bookstore discounts 25.00
Sales staff commissions 8.25
Author royalties 10.00
General and administrative costs 26.25
Total variable costs per copy $92.00
Fixed costs of $100,000 can be estimated quite accurately. Variable costs are linear
and set by contract. List prices are variable, but competition keeps prices within a
narrow range. Variable costs for the proposed book are $92 a copy, and the
expected wholesale price is $100. This means that each copy sold provides the
publisher with an $8 profit contribution.
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Chapter 9
P9.6 SOLUTION
A. Applying the breakeven formula, the breakeven sales volume is 12,500 units,
calculated as
$100, 000
Q= $8
= 12, 500 units.
B. To find the number of copies one must sell to earn a $20,000 profit,
simply add the
$20,000 profit requirement to the book's fixed costs, and then divide this total
amount by the profit contribution per unit. The sales volume required in this case is
15,000 books, found as:
Because fixed costs do not vary with respect
Fixed Costs + Profit Requirement C.
Q= Profit Contribution to changes in the number of books sold, they
should be ignored. Variable costs per copy
$100, 000 + $20,
= are $92, but note that $25 of this cost
$8 000
represents bookstore discounts. Because the
= 15, 000 3,000 copies are being sold directly to the club,
units.
this cost will not be incurred. Hence, the relevant variable cost is only $67 (= $92 -
$25). Profit contribution per book sold to the book club is $10 (= $77 - $67), and
$10 times the 3,000 copies sold indicates that the order will result in a total profit
contribution of $30,000. Assuming that these 3,000 copies would not have been sold
through normal sales channels, the $30,000 profit contribution indicates the increase
in profits to the publisher from accepting this order.
P9.7 Cost Elasticity. Power Brokers, Inc. (PBI), a discount brokerage firm, is
contemplating opening a new regional office in Providence, Rhode Island. An
accounting cost analysis of monthly operating costs at a dozen of its regional outlets
reveals average fixed costs of $4,500 per month and average variable costs of
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Cost Analysis and Estimation
where AVC is average variable costs (in dollars) and Q is output measured by
number of stock and bond trades.
A typical stock or bond trade results in $100 gross commission income, with
PBI paying 35% of this amount to its sales representatives.
A. Estimate the trade volume necessary for PBI to reach a target return of $7,500
per month for a typical office.
B. Estimate and interpret the elasticity of cost with respect to output at the trade
volume found in part A.
P9.7 SOLUTION
A. To earn a target return of $7,500 per month, Power Brokers must generate sufficient
revenues to cover both fixed costs and the target return, or $4,500 + $7,500 =
$12,000 per month. The trade volume necessary to reach a target return of $7,500
per month can be calculated as:
which can be solved using the quadratic formula where a = 0.006, b = 6 and c = -
12,000,
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Chapter 9
Q = - b b2 - 4
ac 2a
= -6 62 - 4(0.006)(-12, 000)
2(0.006)
-6 324
= 0.012
-6 18
=
0.012
= 1, 000 or - 2, 000 trades per month.
Since -2,000 is an infeasible negative output, an activity level of 1,000 trades per
month would allow Power Brokers to meet its target return.
B. By definition,
TC/TC TC Q
c = Q/Q = Q x TC
where
At Q = 1,000,
= $57,500
Therefore, at Q = 1,000
εc = TC x Q
Q TC
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Cost Analysis and Estimation
= ($59Q - $0.012Q2)/TC
= $59(1,000) - $0.012(1,0002)/57,500
= 0.82
Since εC = 0.82 < 1, economies of scale are suggested. A 1% increase in output leads
to a 0.82% increase in costs, and average costs will fall as output expands.
B. At a wholesale price of $5 per case in all states, and assuming sales at the
projected levels, which alternative expansion scheme provides Appalachia with
the highest profit per month?
P9.8 SOLUTION
A. The breakeven output quantity for the single plant alternative is:
TFC
Q =
P - AVC
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Chapter 9
$262, 500
=
$5 -
$3.25
= 150,000 cases per month
The breakeven output quantities for the multiple plant alternative is:
$120, 000
=
QMuncie $5 -
$3
= 60,000 cases per month
$110, 000
=
QNormal $5 -
$3
= 55,000 cases per month
$95, 000
=
QDayton $5 -
$3
= 47,500 cases per month
Thus, the firm-level breakeven quantity for the multiple plant alternative is:
Q = 60,000 + 55,000
+ 47,500
provided that demand was distributed among the states in amounts equal to the
breakeven quantities for each individual plant.
B. Single plant alternative:
π = TR - TC
= P Q - TFC - AVC Q
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Cost Analysis and Estimation
= $87,500
= $75,000
Management would prefer the single plant alternative because of its greater
profitability.
π = TR - TC
= P Q - TFC - AVC Q
= $262,500
π = TR - TC
= $275,000
At peak capacity, management would prefer the multiple plant option because of its
greater profitability.
P9.9 Learning Curves. The St. Thomas Winery plans to open a new production facility in
the Napa Valley of California. Based on information provided by the accounting
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Chapter 9
department, the company estimates fixed costs of $250,000 per year and average
variable costs of
where AVC is average variable cost (in dollars) and Q is output measured in cases of
output per year.
A. Estimate total cost and average total cost for the coming year at a projected
volume of 4,000 cases.
P9.9 SOLUTION
A. The total variable cost function for the coming year is:
TVC = AVC Q
= ($10 + $0.01Q)Q
= $10Q + $0.01Q2
TC = TFC + TVC
= $450,000
AC
= TC/Q
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Cost Analysis and Estimation
= $450,000/4,000
B. Without learning, estimated total cost and average total cost at a volume of 5,000
cases are:
= $550,000
AC = TC/Q
= $550,000/5,000
Since estimated average cost without learning falls between 4,000 and 5,000 units
(see part A), the company is operating in a range of economies of scale.
If actual total costs were $522,500 at a volume of 5,000 cases, actual average
total costs were:
AC = TC/Q
= $522,500/5,000
= $104.50 - $110
Alternatively,
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Chapter 9
AC
Learning Rate = 1 AC21 x 100
-
= 5%
A. Calculate the change in UPS's weekly breakeven output level that is due to
expansion.
B. Assuming that volume remains at two million packages per week, calculate the
change in the degree of operating leverage that is due to expansion.
C. Again assuming that volume remains at two million packages per week, what is
the effect of expansion on weekly profit?
P9.10 SOLUTION
(P - AVC)Q = 1/3P(Q)
P - AVC = 1/3P
AVC = 2/3($12)
AVC = $8
Therefore, the breakeven levels of output before and after expansion are:
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Cost Analysis and Estimation
Before Expansion:
TFC
Q B = P - AVC
Q(P - AVC)
DOL B =
Q(P - AVC) - TFC
2, 000, 000($12 -
=
$8)
2, 000, 000($12 - $8) - $3, 000,
000
= 1.6
After Expansion:
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Chapter 9
Q(P - AVC)
=
DOLA Q(P - AVC) - TFC
2, 000, 000($12 -
=
$6)
2, 000, 000($12 - $6) - $6, 000,
000
= 2 leverage due to expansion is:
The change in degree of operating
Change in
DOL = DOL A - DOLB
=2-
1.6
C. = 0.4
Profits before and after expansion are:
Before Expansion:
πB = (P - AVC)Q - TFC
= $5 million
After Expansion:
πA = (P - AVC)Q - TFC
= $6 million
Change in π =
πA - πB
= $6,000,000 - $5,000,000
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Cost Analysis and Estimation
Cost estimation and cost containment are an important concern for a wide range of for-profit
and not-for-profit organizations offering health-care services. For such organizations, the
accurate measurement of nursing costs per patient day (a measure of output) is necessary for
effective management. Similarly, such cost estimates are of significant interest to public officials
at the federal, state, and local government levels. For example, many state Medicaid
reimbursement programs base their payment rates on historical accounting measures of average
costs per unit of service. However, these historical average costs may or may not be relevant for
hospital management decisions. During periods of substantial excess capacity, the overhead
component of average costs may become irrelevant. When the facilities of providers are fully
used and facility expansion becomes necessary to increase services, then all costs, including
overhead, are relevant. As a result, historical average costs provide a useful basis for planning
purposes only if appropriate assumptions can be made about the relative length of periods of
peak versus off-peak facility usage. From a public-policy perspective, a further potential
problem arises when hospital expense reimbursement programs are based on historical average
costs per day, because the care needs and nursing costs of various patient groups can vary
widely. For example, if the care received by the average publicly supported Medicaid patient
actually costs more than that received by non-Medicaid patients, Medicaid reimbursement based
on average costs for the entire facility would be inequitable to providers and could create access
barriers for some Medicaid patients.
As an alternative to traditional cost estimation methods, one might consider using the
engineering technique to estimate nursing costs. For example, the labor cost of each type of
service could be estimated as the product of an estimate of the time required to perform each
service times the estimated wage rate per unit of time. Multiplying this figure by an estimate of
the frequency of service provides an estimate of the aggregate cost of the service. A possible
limitation to the accuracy of this engineering cost-estimation method is that treatment of a
variety of illnesses often requires a combination of nursing services. To the extent that multiple
services can be provided simultaneously, the engineering technique will tend to overstate actual
costs unless the effect on costs of service "packaging" is allowed for.
Nursing cost estimation is also possible by means of a carefully designed
regression-based approach using variable cost and service data collected at the ward, unit, or
facility level. Weekly labor costs for registered nurses (RNs), licensed practical nurses (LPNs),
and nursing aides might be related to a variety of patient services performed during a given
measurement period. With sufficient variability in cost and service levels over time, useful
estimates of variable labor costs become possible for each type of service and for each patient
category (Medicaid, non-Medicaid, etc.). An important advantage of a regression-based
approach is that it explicitly allows for the effect of service packaging on variable costs. For
Presented by Suong Jian & Liu Yan, MGMT Panel , Guangdong University of Finance.
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Chapter 9
example, if shots and wound-dressing services are typically provided together, this will be
reflected in the regression-based estimates of variable costs per unit.
Long-run costs per nursing facility can be estimated using either cross-section or
time-series methods. By relating total facility costs to the service levels provided by a
number of hospitals, nursing homes, or out-patient care facilities during a specific
period, useful cross-section estimates of total service costs are possible. If case mixes
were to vary dramatically according to type of facility, then the type of facility would have
to be explicitly accounted for in the regression model analyzed. Similarly, if patient mix or
service-provider efficiency is expected to depend, at least in part, on the for-profit or not-for-
profit organization status of the care facility, the regression model must also recognize this
factor. These factors plus price-level adjustments for inflation would be accounted for in a
time-series approach to nursing cost estimation.
Table 9.2 here
To illustrate a regression-based approach to nursing cost estimation, consider a
hypothetical analysis of variable nursing costs conducted by the Southeast Association of
Hospital Administrators (SAHA). Using confidential data provided by 40 regional hospitals,
SAHA studied the relation between nursing costs per patient day and four typical categories of
nursing services. These annual data appear in Table 9.2 The four categories of nursing services
studied include shots, intravenous (IV) therapy, pulse taking and monitoring, and wound
dressing. Each service is measured in terms of frequency per patient day. An output of 1.50 in
the shots service category means that, on average, patients received one and one-half shots per
day. Similarly, an output of 0.75 in the IV service category means that IV services were
provided daily to 75% of a given hospital's patients, and so on. In addition to four categories of
nursing services, the not-for-profit or for-profit status of each hospital is also indicated. Using a
"dummy" (or binary) variable approach, the profit status variable equals 1 for the 8 for-profit
hospitals included in the study and zero for the remaining 32 not-for-profit hospitals.
Table 9.3 here
Cost estimation results for nursing costs per patient day derived using a regression-
based approach are shown in Table 9.3.
A. Interpret the coefficient of determination (R2) estimated for the nursing cost function.
C. Average nursing costs for the eight for-profit hospitals in the sample are only
$120.94 per patient day, or $3.28 per patient day less than the $124.22 average cost
experienced by the 32 not-for-profit hospitals. How can this fact be reconciled with
the estimated coefficient of -2.105 for the for-profit status variable?
Presented by Suong Jian & Liu Yan, MGMT Panel , Guangdong University of Finance.
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Cost Analysis and Estimation
D. Would such an approach for nursing cost estimation have practical relevance for
publicly funded nursing cost reimbursement systems?
A. Cost estimation results provided indicate that R2 = 0.84, meaning that 84% of the
total variation in nursing costs per patient day can be explained by the five factors
studied. For cross-sectional analysis, such a level of cost explanation is often quite
adequate for gaining useful insight concerning cost characteristics.
C. By considering differences in the nursing services provided, along with the for-profit
or not-for-profit status of each hospital, it is possible to learn whether average cost
differences are related to differences in patient mix or, perhaps, to other factors, such
as efficiency or operating philosophy. After accounting for the influences associated
with variation in assorted output categories, the organization design variable appears
relevant. On average, for-profit organizations appear to have nursing costs per
patient day that are at roughly $2.11 less than average, after accounting for a $1.18
cost per day difference that can be attributed to output mix differences. This is an
interesting finding, but additional analysis would be necessary to determine if this
effect is due to operating advantages of for-profit hospitals or instead due to subtle
differences in geographic location, patient mix, and so on.
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Chapter 9
West Virginia, Ohio, and Maryland have implemented Medicaid nursing home
reimbursement systems based on this concept, and several other states have similar
case-mix reimbursement systems under development.
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