?Proton Therapy Center Business Feasibility Plan

Proton Therapy Center Business Feasibility Plan This team assignment is the preparation of a semester-long report/study applying the course contents to the issues of an actual business feasibility plan based on the contents of a case study.The objective of this assignment is to demonstrate through application the course concepts by developing a real-life business feasibility plan (this is short of a full- fledged business plan). It is clear, that given the limited amount of time and resources, the plans can’t be fully fledged, ready-to-go business plans. Especially in the area of final supply side of businesses, teams will have to work with qualified guesses – since this class only introduces the topic of entrepreneurial finances.This assignment is worth twenty (20) percent of the semester grade.You have been asked to develop a Business Feasibility Plan based on the attached Case Study “Proton Cancer Therapy Center: An Entrepreneur’s Dilemma” by Marlene Mints Reed and Rochelle Reed Brunson (2011), Entrepreneurship Theory and Practice, 35: 1091–1100. This case analysis is to serve as the background information and launching-point for teams to being a contemporaneous business planning endeavor. Each team is to select a location for their project different from that of the Case Analysis (i.e., not in Houston, Texas).Team Formation: You are to assemble a team of fellow classmates of your choosing of two (2) or three (3) members. It is expected that all group members make equal contributions to the project. A single grade will be given to all members of the team.Business Feasibility Plan Content: A basic outline of a business plan is as follows. A Business Feasibility Plan differs in that the financial projections are not as robust. In this instance, financial projections will be limited to start-up costs, profit/loss, cash- flow and a breakeven analysis. Otherwise, each of these sections should be fully developed based on the information found within the Case Analysis and through research to being the business plan concurrent with 2018.? Executive Summary? Company/Entity Description ? Market Analysis? Organization & Management ? Services or Product Line? Marketing & Sales? Funding Request? Financial Projections? AppendixMaterials:Relevant materials – articles, examples, forms, teaching notes, etc., for the development of a business plan will be provide during the semester. However, it is recommended that teams begin researching business planning, business plans, start-up guides, etc. to help form the contents of the plan.A recommended initial source is the U.S. Small Business Administration (SBA) and their recommendations for creating a business plan.SBA.gov » Starting & Managing a Business » Starting a Business » Create Your Business Planhttps://www.sba.gov/writing-business-planReference all sources within your document (except for the textbook case analysis) in the accepted ASCE referencing style. To cite material found in the text, use a modified title-page method as follows: (Text, p.x) to identify the page within the textbook.A comprehensive guide to the ASCE reference style is available on the ASCE Website on the “Home / Journals / Authors / Publishing in ASCE Journals” page as the e-book: “Publishing in ASCE Journals: A Guide for Authors.” Refer to the “Referencing” section therein.http://ascelibrary.org/doi/book/10.1061/9780784479…Criteria for the assignment will include elements such as:? Depth of research investigation (covering Case Analyses content, Proton Therapy, medical development, etc.).? Completion of all aspects of the assignment (research, business plan content, translation to contemporary location).? Incorporation of course material.? Writing clarity, organization, conciseness, and grammar.Document: The Proton Therapy Center semester project is to be submitted in PDF form via e-mail and supplied in hardcopy at the time of presentation. Convert all text files (Word Documents), graphics, spreadsheets (Excel Files), or other file types into PDF format and combine into a single cohesive report.Presentation: A twenty (20) minute presentation of the business feasibility plan is to be made. A copy of any presentation materials – PowerPoint slides, handouts, etc. are to be submitted in PDF form via e-mail and supplied in hardcopy at the time of presentation.
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CE 483/583: Engineering Entrepreneurship, Sustainability, and Lean Methods
Dr. Rick Thompson
Title:
Proton Therapy Center Business Feasibility Plan
(A Team Assignment)
Due Date:
Document: Sunday, April 22, 2018 by midnight (via e-mail)
Presentation: Tuesday, April 24, 2018
Description:
This team assignment is the preparation of a semester-long report/study applying the
course contents to the issues of an actual business feasibility plan based on the
contents of a case study.
The objective of this assignment is to demonstrate through application the course
concepts by developing a real-life business feasibility plan (this is short of a fullfledged business plan). It is clear, that given the limited amount of time and
resources, the plans can’t be fully fledged, ready-to-go business plans. Especially in
the area of final supply side of businesses, teams will have to work with qualified
guesses – since this class only introduces the topic of entrepreneurial finances.
Grade Value:
This assignment is worth twenty (20) percent of the semester grade.
Requirements:
You have been asked to develop a Business Feasibility Plan based on the attached
Case Study “Proton Cancer Therapy Center: An Entrepreneur’s Dilemma” by
Marlene Mints Reed and Rochelle Reed Brunson (2011), Entrepreneurship Theory
and Practice, 35: 1091–1100. This case analysis is to serve as the background
information and launching-point for teams to being a contemporaneous business
planning endeavor. Each team is to select a location for their project different from
that of the Case Analysis (i.e., not in Houston, Texas).
Team Formation: You are to assemble a team of fellow classmates of your choosing
of two (2) or three (3) members. It is expected that all group members make equal
contributions to the project. A single grade will be given to all members of the team.
Business Feasibility Plan Content: A basic outline of a business plan is as follows. A
Business Feasibility Plan differs in that the financial projections are not as robust. In
this instance, financial projections will be limited to start-up costs, profit/loss, cashflow and a breakeven analysis. Otherwise, each of these sections should be fully
developed based on the information found within the Case Analysis and
through research to being the business plan concurrent with 2018.
?
?
?
?
?
?
?
?
?
Executive Summary
Company/Entity Description
Market Analysis
Organization & Management
Services or Product Line
Marketing & Sales
Funding Request
Financial Projections
Appendix
Materials:
Relevant materials – articles, examples, forms, teaching notes, etc., for the
development of a business plan will be provide during the semester. However, it is
recommended that teams begin researching business planning, business plans,
start-up guides, etc. to help form the contents of the plan.
A recommended initial source is the U.S. Small Business Administration (SBA) and
their recommendations for creating a business plan.
SBA.gov » Starting & Managing a Business » Starting a Business » Create Your
Business Plan
https://www.sba.gov/writing-business-plan
Referencing:
Reference all sources within your document (except for the textbook case analysis) in
the accepted ASCE referencing style. To cite material found in the text, use a
modified title-page method as follows: (Text, p.x) to identify the page within the
textbook.
A comprehensive guide to the ASCE reference style is available on the ASCE
Website on the “Home / Journals / Authors / Publishing in ASCE Journals” page as
the e-book: “Publishing in ASCE Journals: A Guide for Authors.” Refer to the
“Referencing” section therein.
http://ascelibrary.org/doi/book/10.1061/9780784479018
Evaluation:
Criteria for the assignment will include elements such as:
?
?
?
?
Submission:
Depth of research investigation (covering Case Analyses content, Proton
Therapy, medical development, etc.).
Completion of all aspects of the assignment (research, business plan content,
translation to contemporary location).
Incorporation of course material.
Writing clarity, organization, conciseness, and grammar.
Document: The Proton Therapy Center semester project is to be submitted in PDF
form via e-mail and supplied in hardcopy at the time of presentation. Convert all text
files (Word Documents), graphics, spreadsheets (Excel Files), or other file types into
PDF format and combine into a single cohesive report.
Presentation: A twenty (20) minute presentation of the business feasibility plan is to
be made. A copy of any presentation materials – PowerPoint slides, handouts, etc.
are to be submitted in PDF form via e-mail and supplied in hardcopy at the time of
presentation.
1042-2587
© 2010 Baylor University
E T&P
Proton Cancer
Therapy Center: An
Entrepreneur’s Dilemma
Marlene Mints Reed
Rochelle Reed Brunson
Introduction
John Styles parked his car in the parking lot behind the office of his family business
on Bellaire Boulevard in Houston and eschewing the elevator, walked slowly up the stairs
pondering the unique opportunity afforded his company if he decided to accept it. It had
all started with an offhand remark by his Sunday school teacher suggesting that Styles
should meet a new member of their church who had also devoted his life to health care.
Being one who seldom passed up an opportunity to meet someone else who made their
living in health care, Styles agreed and soon was having lunch with Leon Leach, who
turned out to be the executive vice president of The University of Texas M.D. Anderson
Cancer Center (hereafter called Anderson) in Houston.
Over a long lunch, Leach gave Styles some interesting background on a proposed deal
between Anderson and Tenet Healthcare to build a proton therapy cancer center in
Houston. Unfortunately, the deal had fallen apart because Tenet had evaluated its corporate strategy and decided to refocus on its core managed health-care operations and sell its
proton therapy subsidiary. One thing led to another, and soon, Leach and Styles discussed
the possibility of The Styles Company answering a soon-to-be-released request for proposal (RFP). The company chosen in the RFP would be venturing into a partnership with
Anderson to build the proton therapy center. Styles was excited and intrigued about the
possibilities of such a venture but concerned about putting together a deal that would raise
sufficient funds for the project.
It was now October of 2001, and Styles knew he needed to make a decision soon on
whether or not he would undertake this project.
Please send correspondence to: Marlene Mints Reed, tel.: (254) 710-4868; e-mail: marlene_reed@baylor.edu
and to Rochelle Reed Brunson at rochelle_brunson@baylor.edu.
September, 2011
DOI: 10.1111/j.1540-6520.2010.00401.x
etap_401
1091..1102
1091
The Styles Company
John H. Styles, the senior member of the Styles Company, grew up in Seymour, Texas,
and received a scholarship to play football at Baylor University in Waco, Texas. He had
grown up under difficult economic circumstances with parents who worked hard to
support the family. Styles often suggested to people that he could never have attended
college if it had not been for the fact that Baylor offered him a scholarship. After
completing a degree in Business Administration at the Hankamer School of Business at
Baylor, Styles was offered a teaching/coaching job in his hometown. He took the job but
was only able to coach and teach for 2 years on an emergency teaching certificate because
he did not have certification in secondary education.
After a short stint in Wichita Falls, Styles went to work as the Controller/Chief
Financial Officer for Providence Hospital (owned by the Catholic Church) in Waco, Texas,
in 1966. It was during his time at Providence Hospital that he became aware of the
payment provisions under the newly implemented Medicare law that would revolutionize
the health care industry. It became clear to him that hospitals such as Providence, which
had formerly operated at breakeven or a loss in the past, would now find themselves doing
much better financially. One of the reasons for this was the guaranteed payments by the
government for the elderly who were able to pay very little in the past.
Styles, secure in the knowledge that health care was the industry he was interested in,
took a couple of other executive-level health-care jobs in Louisiana and Arkansas. In
1974, he moved to Houston, which, with the Texas Medical Center, was becoming a
health-care mecca. Arriving in Houston, he became the Senior Operations Officer for
LIFEMARK Corporation (previously Medenco, Inc.). This New York Stock Exchange
company had grown from scratch and owned more than 50 hospitals and was sold in 1984
to American Medical International.
After the sale of LIFEMARK, Styles became a founding investor in HealthSouth
Corporation and Founder/CEO of Outpatient Healthcare, Inc., and eventually, MidAmerica Healthcare Group, which owned and managed numerous hospitals. Both Outpatient Healthcare and Mid-America were sold to Columbia/HCA in 1991 and 1995,
respectively.
One of Styles’s personal goals was to provide a good living for his family so that they
would not have to face the scarcity that he had faced as a child, and if possible, he wanted
to involve as many members of his family in the businesses that he started as wanted to be
involved.
The success of the many health-care businesses that he founded gave him the capital
and the personal motivation to continue to launch new enterprises. He developed a
strategy of keeping his eyes open for promising ventures, assessing their potential value,
and investing in those that showed the promise of providing the financial rewards that he
needed as well as the satisfaction that he had helped others achieve a level of health care
that they needed.
At the time of the proposal to work with Anderson, Styles had been actively involved
in health-care-related business ventures for 35 years. Two of Styles’s sons and one of his
grandsons had also been involved all of their working lives with the health-care industry.
John H. Styles, Jr. had more than 25 years of operational experience in hospital and
health-care-related business. He had been involved in the design, construction, development, ownership, and management of businesses including acute care hospitals, rehabilitation hospitals, ambulatory surgery centers, medical office buildings, cancer treatment
facilities, and cancer research facilities.
1092
ENTREPRENEURSHIP THEORY and PRACTICE
A younger son, Jason Styles, had been a cofounder and executive vice president of
corporate affairs for Triumph Healthcare prior to its sale in 2004. He also had served as
a corporate finance executive with Harris Webb & Garrison (precursor of Sanders Morris
Harris, Inc.). At Harris Webb, he was involved in numerous transactions including private
placements, valuations, equity and debt financings, and mergers and acquisitions. He
assisted in the closing of more than $400 million in equity and debt offerings in various
industries including health care. He also served in several capacities for Mid-America
Healthcare Group prior to the sale of its assets to Columbia/HCA.
The Styles Company was formed as a vehicle to consolidate the management and
operations of various investments of its principals—John Styles, Sr. and his sons. The
investments were primarily involved in health care and real estate ventures. The Styles
Company provided complete project development and management duties including the
following:
studies
• Feasibility
Project
financing
• Selection and management of architectural, engineering, and interior design
• Real estate acquisition
• Equipment procurement and oversight of installation
• Long-term management services.
•
Proton Cancer Treatment
The goal of all cancer therapies had been to selectively destroy cancer cells while
sparing normal tissue. Some of the medical techniques that had been used for the treatment of cancer were surgery, chemotherapy, and radiation therapy. Proton therapy was just
a newer form of radiation treatment.
The Proton Process
As early as 1946, the physicist Robert Wilson believed that protons could play a
significant role in cancer treatment because of their advantageous dose distributions
(Wilson, 1946). The process was such that when proton beams interacted with matter, they
produced energy depositions that were characterized by a relatively low dose in the
shallow regions of their path; however, near the end of the proton range, the dose rose
sharply to a peak and then fell abruptly to zero. The result was that a high dosage of
ionizing radiation could be delivered to a deep-seated tumor while not harming the
surrounding normal tissues. Compared with an X-ray beam, a proton beam had a low
“entrance dose” (the dose delivered from the surface designed to cover the entire tumor)
and no “exit dose” beyond the tumor. See Figure 1 entitled “Diagram of Proton Cancer
Therapy” for a description of this process.
The outcome of this type of cancer treatment was so successful that by the year 2000,
nearly 40,000 patients at 25 cancer centers around the world had received proton therapy
treatment. One of the advantages of proton therapy was that this treatment had fewer side
effects as compared with other types of cancer treatment.
Prospective Patients
Proton therapy was recommended for patients whose tumor: (1) was localized; (2)
required high doses of radiation for control; and (3) was located near tissues or organs
September, 2011
1093
Figure 1
Diagram of Proton Cancer Therapy
Table 1
Proton Therapy Historical Timeline
1946—Wilson published his proton therapy theories
1954—Lawrence Berkley Lab initiated human trials
1961—Harvard opened its cyclotron laboratory
1975—Russian scientists built a St. Petersburg cyclotron center
1981—Magnetic resonance imaging first demonstrated
1985—Scientists formed the Proton Therapy Cooperative Group
1990—Loma Linda opened a proton therapy center
1994—Harvard initiated design on the Northeast Proton Therapy Center
sensitive to radiation therapy. The types of tumors most often selected for proton therapy
were cancers of the prostate, eye, lung, brain, head, and neck. Proton treatment had also
been found to be useful in treating cancers in children.
Locations for Proton Therapy
In 2000, there were 19 proton therapy facilities around the world that had treated
nearly 29,000 patients. Loma Linda University Medical Center was the first such center in
the United States, and it opened in 1990. Other proton facilities were planned at Massachusetts General Hospital in Boston, Indiana University in Bloomington, the University of
Florida in Jacksonville, and the University of Pennsylvania in Philadelphia. Table 1
describes the timeline for development of proton cancer therapy.
The M.D. Anderson Cancer Center
The M.D. Anderson Cancer Center was established in Houston in 1941 by a
$1 million fund that was financed jointly by the State of Texas and the M.D. Anderson
1094
ENTREPRENEURSHIP THEORY and PRACTICE
Foundation. The cancer center became a part of the University of Texas medical system.
In 2000, Anderson was ranked as the number one cancer hospital in the United States by
U.S. News & World Report primarily based on its reputation among board certified
physicians and its low mortality rates. Since 1990, M.D. Anderson had been ranked
among the nation’s top two cancer hospitals. Statistics for the year 2000 indicated that
during the past year, M.D. Anderson had treated 52,000 cancer patients and recorded over
448,000 outpatient office visits. Anderson also employed nearly 16,000 employees including 840 faculty members.
Patient Census Trends
From 1996 to 2000, M.D. Anderson’s inpatient census increased by 16% while
outpatient visits increased by 32%. In addition, over 43% of Anderson’s patients were
self-referred, which Anderson perceived to be reflective of the center’s reputation and its
marketing programs.
The Radiation Oncology (“RO”) division was a leader within the M.D. Anderson
system. The RO division employed over 350 professional faculty and staff in nonresearch
positions, and in the year 2000, provided conventional radiation therapy to over 370
patients per day. The division projected net revenues of nearly $50 million and operating
margins of 28% for 2001 and had experienced a 17% compounded annual growth rate in
net revenues from 1996 to 2001. However, due to capacity constraints, over half of all
Anderson patients who required radiation therapy used outside facilities such as community hospitals and freestanding oncology centers to obtain their radiation treatments.
Cancer Trends and Capacity Issues
The second leading cause of death in the United States in 2000 was cancer. Only heart
disease claimed more lives than cancer. In fact, one in four deaths in the United States in
the beginning of the twenty-first century was caused by cancer.
In the 10 years from 1990 to 2000, nearly 15 million new cancer cases had been
diagnosed in the United States. Over half of all new cancer cases were located in the
following four sites: lung, prostate, breast, and colorectal. The annual cost for cancer
treatment in 2000 was $107 billion—$37 billion of which was devoted to direct medical
costs, $11 billion for lost productivity due to the illness, and $59 billion for lost productivity due to premature death (Sanders Morris Harris, 2001).
Although the incidence of cancer in the population was expected to increase in the
twenty-first century due to population growth and the aging of the population in general,
cancer diagnosis rates were also rising because of better diagnostic tools. The earlier
detection of cancer would increase the need for therapies designed to treat the newly
diagnosed cases.
Since proton therapy was a type of radiation therapy, the question arose as to the
ability of M.D. Anderson Cancer Center to handle the capacity needs of a growing
population of cancer patients. Table 2 indicates the radiation oncology capacity surplus or
deficit projections through the year 2006.
If a proton cancer therapy center were to be built in Houston, M.D. Anderson and the
University of Texas System owned four acres of land near the Texas Medical Center in
Houston where the facility could be located. The University of Texas System had suggested that arrangements could be made to offer a 60-year lease to the Center for its
operations. The rationale for that was that M.D. Anderson was regularly identified as the
top cancer hospital in the nation, and it made sense to locate this cutting-edge cancer
technology nearby.
September, 2011
1095
Table 2
M.D. Anderson Division of Radiation Oncology
Current patients treated
Projected increased capture†
Total patients treated
Existing capacity‡
Expansion capacity§
Total capacity
Surplus (deficit)
2000
2002
2004
2006
3,977
0
3,977
3,745
0
3,745
(232)
4,332
0
4,332
4,529
0
4,529
197
4,947
1,671
6,618
4,529
1,889
6,418
(200)
5,627
1.952
7,579
4,529
1,889
6,418
(1,161)
†
Includes combined modality treatments and additional penetration of M.D. Anderson patient base equal to approximately
7.5% of new cancer cases annually beginning in 2004.
‡
Assumes increase from 10.8 available treatment rooms in 2000 to 13.0 in 2002.
§
Assumes completion and commissioning of eight additional treatment rooms in new ambulatory clinical building in 2004.
The Styles Company and Anderson had estimated that approximately 92,500 square
feet would be needed for the facility, which would include state-of-the-art equipment, four
patient treatment rooms, and a particle-accelerator-based proton system. In addition, the
space would provide for research and patient support services to be offered. Calculations
on the project concluded that the total cost of the facili …
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