Written for a finance committee, an NU513 Unit 10 plan builds a heart failure service line in two gated phases and admits the clinic loses money until readmission gains arrive. Searches like "nu 513 unit 10 assignment example", "nu513 unit 10 sample" and "nu513 unit 10 example" land here.
A Heart Failure Service Line in Two Gated Phases: A Strategic Plan Written for the Committee That Would Pay for It
[Student Name]
Purdue University Global
NU513: Health Care Finance, Economics, and Strategic Planning
Unit 10 Assignment
[Instructor Name]
[Date]
The hospital, market and financial figures are composite and bracketed; the evidence and payment program cited are published.
Executive Summary
Request: fund phase one, a heart failure nurse navigator, at $126,379 a year for two years.
Release condition for phase two: a 30-day all-cause readmission rate for heart failure discharges below [18.0] percent for two consecutive quarters, from a baseline of 21.2 percent.
Phase two, requested only if the condition is met: a nurse-led transitional clinic, bringing total annual operating cost to $294,774.
Financial position: phase two's direct revenue and refilled beds do not cover its operating cost. The case rests on reducing the heart failure share of the hospital's readmissions penalty, about $229,900 a year, and on the navigator's and clinic's effect on avoidable days and readmissions.
Market and Current State
1. Volume: 588 heart failure discharges a year from the medicine unit, [64] percent Medicare.
2. Outcomes: 30-day all-cause readmission rate 21.2 percent; average stay 4.9 days, 1.1 longer than the DRG benchmark.
3. Penalty: the heart failure contribution to the hospital's Hospital Readmissions Reduction Program penalty is about $229,900 a year of a $291,200 total.
4. Competition: a competing system operates a heart failure clinic [22] miles away and has begun marketing it to cardiology practices in the hospital's area.
5. Ownership: heart failure patients pass through the emergency department, the medicine unit, cardiology, pharmacy and home health. Each department manages its part; nobody manages the path.
That last fact is why a service line, rather than another unit project, is the right scale. Unit projects have improved discharge teaching, but a readmission usually begins after the patient has left the unit, in a gap no single department owns.
What the Evidence Supports
A systematic review of 47 trials of transitional care for heart failure found that home-visiting programs and multidisciplinary heart failure clinics reduced all-cause readmissions over three to six months, and that structured telephone support reduced heart-failure-specific readmissions; primarily educational interventions did not reduce readmission (Feltner et al., 2014). The plan therefore builds the navigator role around follow-up contact and clinic access, not around more education at discharge, because education alone is the one approach the review found ineffective. Nurse-led transitional care for older adults has also reduced readmissions in randomized trials (Naylor et al., 1999).
Phase One: The Navigator
Role: a registered nurse who identifies every heart failure admission within 24 hours, reconciles medications with pharmacy, confirms a follow-up appointment within seven days before discharge, calls each patient within 72 hours of discharge, and triages symptoms and weight gain by phone for 30 days under a standing protocol with cardiology.
Cost: salary and benefits for one FTE at a bracketed loaded rate, plus phone and documentation support, $126,379 a year.
Expected effect: if the navigator lowers the readmission rate from 21.2 to 18.0 percent, about 19 fewer readmissions a year. Each avoided readmission frees a bed for about [4.9] days for another admission and, over the three-year measurement window, moves the heart failure excess readmission ratio toward the peer median.
Phase Two: The Transitional Clinic
Role: a nurse practitioner and a registered nurse see high-risk heart failure patients within seven days of discharge and at intervals over 60 days, adjusting diuretics and coordinating with cardiology.
Operating cost at full operation, including the navigator: $294,774 a year. Visit revenue: a bracketed [$171,100] a year. Contribution from refilled beds: [$28,421] a year. Direct net: minus $95,253 a year.
The plan says this plainly. The clinic does not pay for itself from visits and beds. Its financial case depends on the readmissions penalty and on the service line's strategic value against the competing clinic.
Three-Year Projection, Base Case
Year one: navigator only. Cost $126,379. No change in penalty yet, because the program measures performance over three years. Year two: navigator; clinic opens mid-year if the release condition is met. Cost about [$210,600]. Penalty begins to fall as year one's improved performance enters the measurement window. Year three: full operation, cost $294,774. If the hospital's heart failure ratio has fallen to the peer median, the heart failure share of the penalty, about $229,900, is no longer charged, and the direct net loss of $95,253 is more than offset.
The projection is sensitive to the penalty's timing and to peers' performance. If peer hospitals improve as fast as this one, the ratio may not fall below the median even with real improvement, and the penalty offset would not arrive (McIlvennan et al., 2015).
Governance
A heart failure service line director, a physician and nurse dyad from cardiology and the medicine unit, would own the path from admission to 60 days after discharge, report quarterly to the finance committee and hold the navigator and clinic budgets. That is the owner the patients do not currently have.
Measures and Gates
Reported quarterly: 30-day all-cause readmissions for heart failure; share of patients seen within seven days of discharge; length of stay against the geometric mean; navigator contacts within 72 hours; and the hospital's heart failure excess readmission ratio when CMS reports it. Phase two is released only by the readmission condition. If the condition is not met after two years, the committee should reconsider the navigator itself rather than fund the clinic.
Risks
The penalty offset depends on peers and on a three-year lag. The competing clinic may draw patients away. The navigator may be pulled into inpatient work. Each is addressed by the dyad's governance and the quarterly gates, and none requires the committee to commit to phase two now.
References
Feltner, C., Jones, C. D., Cené, C. W., Zheng, Z.-J., Sueta, C. A., Coker-Schwimmer, E. J. L., Arvanitis, M., Lohr, K. N., Middleton, J. C., & Jonas, D. E. (2014). Transitional care interventions to prevent readmissions for persons with heart failure: A systematic review and meta-analysis. Annals of Internal Medicine, 160(11), 774-784. https://doi.org/10.7326/M14-0083
McIlvennan, C. K., Eapen, Z. J., & Allen, L. A. (2015). Hospital Readmissions Reduction Program. Circulation, 131(20), 1796-1803. https://doi.org/10.1161/CIRCULATIONAHA.114.010270
Naylor, M. D., Brooten, D., Campbell, R., Jacobsen, B. S., Mezey, M. D., Pauly, M. V., & Schwartz, J. S. (1999). Comprehensive discharge planning and home follow-up of hospitalized elders: A randomized clinical trial. JAMA, 281(7), 613-620. https://doi.org/10.1001/jama.281.7.613
How this NU513 Unit 10 example is structured
A funding decision organizes the plan, and every section serves it. The summary asks for less than the full plan, because a committee can approve a navigator on modest evidence and a clinic only on results. The market section establishes why a service line, rather than another unit project, is the right scale: heart failure patients pass through the emergency department, the medicine unit, cardiology and home health, and nobody owns the whole path. The financial projection is candid. Clinic revenue and refilled beds do not cover operating cost, and the plan says so; the case rests on the heart failure portion of the readmissions penalty, $230,649 in the Unit 4 estimate, which reaches payment only after a lag of years. Gates convert that uncertainty into decisions: readmissions below a bracketed 19 percent for two quarters release phase two. Governance and risks follow.
Get an NU513 Unit 10 example written to your instructions
Bring the service your plan will address, any volume or cost figures your case includes, and the Unit 10 prompt with its rubric. A model service line plan aimed at finance readers, with phases and gates, returns in 24-48h, free on a first request. Standing behind the plan in front of funders is something no model does for you. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU513 Unit 10 questions, answered
Is a service line plan different from a unit strategic plan?
Yes. A unit plan covers one department; a service line organizes care for a condition or population across several departments, with its own finances and leadership. The sample's heart failure service line spans the emergency department, a medicine unit, cardiology and home health. That scope is why it needs co-leads and a funding case built across department budgets.
What if my projection shows a loss?
Show it, and explain what closes the gap. Many worthwhile programs lose money on direct revenue and justify themselves through avoided costs, penalties or strategic position. The sample projects a year-two loss and ties the case to the readmissions penalty, with gates to limit the committee's exposure. Hiding a loss rarely survives a finance reader's check of the arithmetic.
How detailed should the market analysis be?
Enough to show demand and competition with sources. Volume from your hospital's records, payer mix and nearby competing programs normally suffice. Population data from state or county health reports can support growth assumptions. The sample keeps its market section to a page, since the committee's main question concerns return and risk rather than market size.