Healthcare administration fellow at the prestigious Stanford Healthcare.

familiarize you with financial statements, the need to align the financials and the strategic direction of the firm, and the process of performing horizontal and vertical analyses of a company's balance sheets and income statements.

You will be provided with a scenario and a variances analysis. You will use the information in both to create a memo in which you demonstrate your audit financial statements and expenditures based on organizational priorities.

Instructions
Scenario
You're a healthcare administration fellow at the prestigious Stanford Healthcare. You have been rotating through the various departments over the past nine months and now you have the honor of working under the mentorship of Chief Financial Officer Linda Hoff.

Stanford Medicine includes Stanford Healthcare, Stanford Children's Hospital, and Lucile Packard Children's Hospital Stanford. This organization uses an integrated approach to strategic planning, which incorporates jointly agreed-upon strategic priorities from its various entities. It also ensures a high degree of congruence in strategic focus by each entity.

Before outlining the strategic priorities for Stanford Medicine, it is important to note that a firm's directional strategy comprises three discrete yet interwoven components: vision, mission, and goals (or, in this case, priorities). Armed with this knowledge, you have familiarized yourself with the vision, mission, and priorities of Stanford Medicine. Below is what you found.

When examining a company's financials, it is prudent to keep the directional strategy of the company in mind. After all, in order to advance many strategic priorities, which include fulfilling the mission and positioning the organization to achieve its vision for the future, proper management of the firm's scarce resources is vital. Failure to properly manage the financial performance of the organization can compromise the company's ability to maintain a competitive advantage in the marketplace.

Our Vision
Precision Health: Predict. Prevent. Cure. Precisely.

We will heal humanity through science and compassion by leading the biomedical revolution in precision health.

Our Mission
Improving Human Health Through Discovery and Care.

Through innovative discovery and the translation of new knowledge, Stanford Medicine improves human health locally and globally. We serve our community by providing outstanding and compassionate care. We inspire and prepare the future leaders of science and medicine.

Strategic Priorities
A collaborative endeavor involving the entire community, the Stanford Medicine integrated strategic planning process yielded a framework that is human-centered and discovery-led, focused on three overarching priorities for our enterprise.

By enhancing our strengths and achieving our goals in these priority areas, we will amplify our preeminence and remain uniquely positioned to lead the biomedical revolution in precision health, ensuring our continued ability to guide healthcare through significant global changes.

Value Focused
Provide a highly personalized patient experience.

Ensure a seamless Stanford Medicine experience.

Digitally Driven
Amplify the impact of Stanford innovation globally.

Deliver human-centered, high-tech, high-touch care and revolutionize biomedical discovery.

Lead in population health and data science.

Uniquely Stanford
Accelerate discovery in and knowledge of human biology.

Discovered here, used everywhere: advanced fundamental human knowledge, translational medicine, and global health.

Ensure preeminence across all our mission areas.

Variance Analyses
Normally, managers are expected to examine positive and negative variances, and then speculate as to possible explanations for the observed variances. Following this initial assessment, managers would be expected to dig deeper into those variances of greatest concern to the organization to uncover the actual causes for the variances, and then implement necessary corrective actions. Digging into all variances would be costly and, quite frankly, a misuse of time and energy.

The CFO asked one of her financial analysts to conduct a variance analysis of the company's consolidated balance sheets and income statements for fiscal years 2015, 2016, 2017, and 2018, which has been completed. The analyst determined the variances for each account (line item) captured in the financials. Now that this first step has been accomplished, the CFO would like you to pay particular attention to the negative variances contained in the spreadsheet and focus on those variances you believe to be potentially the most impactful to Stanford.

The financial analyst completed your variance analysis over time, which is referred to as a horizontal analysis, and then proceeded to create a common-size balance sheet and income statement for each of the four fiscal years (2015-2018). The common-sized financials are captured in the provided spreadsheet.

Financial Management and Strategic Direction
Once you've completed your horizontal and vertical analyses of the financial statements, you should be able to get a sense of how well management has managed the financial resources of the company in support of its strategic direction. In business, the strategic direction should be evident in its vision and mission statements, and strategic priorities. The strategic priorities should support the company's mission, and the mission should help advance the firm's vision for the future. Failure to effectively manage the company's financial resources can seriously compromise the firm's ability to fulfill its mission and, subsequently, its vision.

Submission
Based on the provided scenario, create a 3-4 page business memorandum to Linda Hoff, Stanford's CFO. For guidance on writing a memo, take a look at this Sample Memo [DOCX] Download Sample Memo [DOCX].

In your memo, codify your findings and interpretations from the horizontal and vertical analyses and the level of alignment in the company's fiscal management and strategic direction. Include the provided Excel spreadsheet you used to complete your analysis as an attachment to the memo. In this memo, you will:

Review the year-over-year variances contained in the audited Stanford balance sheets and income statements for fiscal years 2015-2018 in the  Week 5 Assignment Spreadsheet [XLSX] Download Week 5 Assignment Spreadsheet [XLSX]. You'll be expected to pay particular attention to the negative variances (color-coded in red) that you believe to be potentially the most impactful to Stanford and provide a rationale for that belief.
Hypothesize as to the reasons for the negative variances. Be sure the hypothesis is supported by evidence from the scenario, the balance sheets, and income statements.
Explain the proportional changes in the common size results over the four fiscal year time frame and identify notable changes in the ratios. Also include a hypothesis, supported by a rationale, to suggest why these anomalies may exist.
Identify notable patterns and variances that warrant further investigation and justify both with evidence from the three-year period. Specify the potential consequences of the variances to justify the need to examine these variances further.

Full Answer Section

         

MEMORANDUM

To: Linda Hoff, CFO

From: [Your Name], Healthcare Administration Fellow

Date: October 26, 2023

Subject: Analysis of Stanford Medicine Financial Statements and Alignment with Strategic Direction

This memorandum presents a comprehensive analysis of Stanford Medicine's financial statements for fiscal years 2015-2018, focusing on negative variances and their potential impact on the organization's strategic direction. The analysis was conducted using horizontal and vertical analyses of the provided balance sheets and income statements, and it highlights areas that warrant further investigation.

Horizontal Analysis:

A horizontal analysis reveals significant negative variances in specific accounts over the four-year period, suggesting potential concerns regarding the financial health and strategic alignment of Stanford Medicine.

  • Operating Expenses: There is a consistent increase in operating expenses over the four years, with a notable surge in 2018. This trend is particularly concerning considering Stanford Medicine's strategic priority of achieving operational efficiency.

  • Net Income: Despite growing revenues, net income has declined significantly in 2018, potentially due to the aforementioned increase in operating expenses. This negatively impacts the organization's ability to invest in research, innovation, and future growth initiatives.

  • Patient Service Revenue: While patient service revenue has grown steadily, the growth rate has slowed in recent years, indicating potential market pressures or a need to refine revenue generation strategies.

Hypothesis for Negative Variances:

The significant increase in operating expenses, particularly in 2018, could be attributed to several factors:

  • Expansion Initiatives: Stanford Medicine's commitment to expanding services and research may have led to increased staffing, technology investments, and facilities costs.

  • Inflation: The rising cost of healthcare supplies, utilities, and labor may have contributed to the increase in operating expenses.

  • Increased Competition: The presence of for-profit facilities might be driving up costs to maintain a competitive advantage in the market.

Vertical Analysis:

The vertical analysis of common-size financial statements reveals notable patterns and variances that require further investigation.

  • Patient Service Revenue: While the percentage of patient service revenue has remained relatively stable, the slight decline in 2018 warrants attention. This could indicate a shift in patient mix, changing market dynamics, or a potential need to enhance revenue cycle management.

  • Operating Expenses: The percentage of operating expenses has consistently increased, particularly in 2018, indicating a growing strain on profitability. This could be due to factors mentioned in the hypothesis above.

  • Net Income: The significant decline in net income as a percentage of revenue in 2018 is concerning. It highlights the need to address the rising operating expenses and maintain a sustainable financial model.

Notable Patterns and Variances:

  • Growing Operating Expense Ratio: The increasing operating expense ratio in 2018 requires immediate attention. This could be a symptom of inefficiencies, unchecked cost growth, or inadequate financial management.

  • Declining Net Income Margin: The decline in net income margin in 2018 raises concerns about the organization's ability to meet financial commitments and invest in future growth.

  • Shift in Patient Service Revenue: The subtle decrease in patient service revenue as a percentage of total revenue suggests a need to analyze patient mix and market trends to identify any potential shifts in demand or competitive pressures.

Consequences of Unchecked Variances:

  • Compromised Strategic Priorities: Continued increases in operating expenses could hinder Stanford Medicine's ability to pursue its strategic priorities, such as investing in innovation, expanding services, or achieving operational efficiency.

  • Reduced Financial Stability: The decline in net income and profit margin could lead to financial constraints, limiting the organization's ability to meet its financial obligations and invest in research and development.

  • Erosion of Competitive Advantage: Failing to address cost pressures and maintain financial stability could erode Stanford Medicine's competitive advantage in the market.

Recommendations:

  • Conduct a Deeper Dive: A more detailed analysis of the individual components of operating expenses is necessary to identify specific drivers of cost increases and develop strategies for mitigating those costs.

  • Review Revenue Generation Strategies: Examine patient mix, market trends, and revenue cycle management practices to identify opportunities for improving revenue generation.

  • Enhance Financial Management: Implement robust financial management systems and processes to ensure optimal resource allocation, cost control, and efficient operations.

  • Strengthen Strategic Alignment: Continuously evaluate the organization's strategic priorities and ensure that financial decisions and resource allocation directly support these goals.

Conclusion:

The analysis of Stanford Medicine's financial statements highlights the importance of aligning financial management with strategic direction. While the organization has made significant progress in achieving its vision and mission, the observed negative variances and declining financial metrics require immediate attention. Addressing these concerns and implementing effective financial management strategies are crucial for ensuring the continued success and sustainability of Stanford Medicine.

Sample Answer