| Course | NR 517 Policy & Economics of Healthcare Delivery |
|---|---|
| Week | 4 |
| Paper type | Cost analysis |
| Length | About 1,120 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Healthcare Policy |
| Updated | September 2026 |
Free sample paper for NR 517 Week 4
Cost Analysis Write-Up: What a Nurse-Led 30-Day Follow-Up Program for Hip Fracture Patients Would Cost a Community Hospital, and the Assumptions Under Each Number
Student Name
College of Nursing, Chamberlain University
NR 517: Policy & Economics of Healthcare Delivery
Instructor Name
Month Day, Year
Cost Analysis Write-Up: What a Nurse-Led 30-Day Follow-Up Program for Hip Fracture Patients Would Cost a Community Hospital, and the Assumptions Under Each Number
The Service Being Costed
The service is a nurse-led follow-up program for patients discharged after surgical repair of a hip or femur fracture at a 180-bed community hospital. A registered nurse would telephone each patient, or the skilled nursing facility caring for them, on days 2, 7 and 21 after discharge, check pain, mobility, wound, medications and warning signs, confirm that a primary care appointment is booked, and pass problems to the surgeon's office or primary care. The program would run for the 30 days after discharge, the window of the Medicare episode model in which the hospital now participates (Centers for Medicare & Medicaid Services, n.d.-b). The analysis estimates the cost to the hospital. It does not estimate savings, which are a separate question for later in the course.
The Calculation
Table 1 shows the figures. Every number is followed by its source or labeled as an assumption.
Table 1
First-Year Cost of a Nurse-Led 30-Day Follow-Up Program
| Item | Value | Source or assumption |
|---|---|---|
| RN median hourly wage | $46.90 | U.S. Bureau of Labor Statistics, May 2025 |
| Benefits and payroll load | 30% | Assumption, from the hospital finance office's standard load |
| Loaded hourly cost | $60.97 | $46.90 x 1.30 |
| Nurse time per patient | 100 minutes (1.67 hours) | Assumption: three calls of 20, 20 and 15 minutes, 15 minutes of documentation, 20 minutes of coordination, 10 minutes of scheduling |
| Cost per patient | $101.62 | 1.67 hours x $60.97 |
| Patients per year | 110 | Assumption, from the operating room log of hip and femur fracture repairs in the last 12 months |
| Annual nurse cost | $11,177.83 | 110 x $101.62 |
| One-time build of an electronic call template | $440 | Assumption: 8 analyst hours at $55 an hour, per the informatics department |
| First-year total | $11,617.83 | $11,177.83 + $440 |
Defending the Wage
The wage is the national median for registered nurses, $46.90 an hour in May 2025 (U.S. Bureau of Labor Statistics, n.d.). A national median was chosen over the hospital's own pay scale because the pay scale is confidential and because the program could be staffed by nurses at different steps. Using the median is conservative in one direction and optimistic in another: an experienced orthopedic nurse at this hospital probably earns more, while a nurse early in the scale earns less. The benefits load of 30% is the figure the finance office applies to all nursing positions; it covers payroll taxes, health insurance and retirement contributions. It is an internal assumption, not a published figure, and the analysis says so.
Defending the Time
The 100-minute estimate is the assumption most likely to be wrong, so it is built from parts rather than guessed as a whole. Three calls were timed during a two-week trial run by two nurses on the unit with eight patients: the first call, when problems are most likely, averaged about 20 minutes; the second about 20 minutes; the third, when most patients are settled, about 15. Documentation and coordination with the skilled nursing facility or physician office were timed separately. The trial was small and the patients were not chosen at random, so the estimate is a starting point, not a measurement.
Two things were excluded. The patient's own time and the time of skilled nursing facility staff answering calls are real costs, but they fall on others, not on the hospital. The analysis is written from the hospital's point of view, and a different viewpoint, such as Medicare's or society's, would count them.
How Sensitive the Answer Is
Because time per patient drives almost all of the cost, the analysis was repeated with 80 and 120 minutes per patient. At 80 minutes, the cost per patient is $81.29 and the annual nurse cost is $8,942.27. At 120 minutes, it is $121.94 per patient and $13,413.40 a year. If the wage were 20% higher than the national median, the loaded hourly cost would rise to $73.16, and the annual nurse cost at 100 minutes would rise by the same 20%. Across these variations, the program costs between roughly $9,000 and $16,000 a year in nurse time. The range matters more than the central figure: a decision maker should know that the true cost could be half again as large as the estimate.
Costs Deliberately Left Out
Three hospital costs were left out on purpose, and each is named so a reader can add it back. The first is supervision: a nurse manager would spend some time overseeing the program, but that time is already paid and would be absorbed rather than added. The second is space and telephones, which the unit already has. The third is training, estimated at two hours per nurse for four nurses, about $488 at the loaded rate, which was omitted because the same nurses already make discharge calls for other patients and the new script is short. If the finance office prefers to count training, the first-year total rises to about $12,106. Leaving an item out is acceptable in a cost analysis; leaving it out without saying so is not.
What the Number Means Under Each Payment Arrangement
Under traditional fee-for-service Medicare, this program brings the hospital no additional revenue. The hospital's payment for each hip fracture stay is fixed, and post-discharge phone calls are not separately billable in this design. The full cost is borne by the hospital.
Under the episode model, the cost may be recovered if the calls reduce Medicare spending during the 30 days after discharge, for example by catching problems before they lead to an emergency visit or readmission, since hospitals whose episode spending falls below the target price may receive a payment (Centers for Medicare & Medicaid Services, n.d.-b). Whether that happens depends on how many costly events the calls prevent, which this analysis does not estimate. What the analysis does establish is the size of the bet: roughly $11,600 in the first year, with a plausible range of $9,000 to $16,000.
The analysis also leaves the question of who should run the program open. A single dedicated nurse would make the calls more consistent but would concentrate the work in one person, while spreading calls across the unit's day nurses would fit them around patient care but risk their being skipped on busy days. The cost is the same either way; the reliability is not, and the unit should decide before the program starts.
References
Centers for Medicare & Medicaid Services. (n.d.-b). Transforming Episode Accountability Model (TEAM). Retrieved September 30, 2026, from https://www.cms.gov/priorities/innovation/innovation-models/team-model
U.S. Bureau of Labor Statistics. (n.d.). Registered nurses. Occupational Outlook Handbook. Retrieved September 30, 2026, from https://www.bls.gov/ooh/healthcare/registered-nurses.htm
The Chamberlain NR 517 Week 4 instructions
In Week 4 you estimate what it costs to deliver a service, program or intervention. Prompts usually ask you to define the service, identify cost components, estimate the costs with sources, state assumptions, and discuss the financial implications for the organization. Some sections also ask for a break-even or return-on-investment discussion. The arithmetic is usually simple; the grade depends on whether each number can be traced and defended. Bound the service tightly, choose a viewpoint such as the hospital's, and label every figure as sourced or assumed. Check whether your section wants a table, which cost categories it expects and whether savings must be estimated or only discussed.
Inside the NR 517 Week 4 example
The example defines the service precisely, three calls in 30 days with coordination, and states that it costs the program from the hospital's viewpoint without estimating savings. A table lists nine lines, each with its source or assumption, from the $46.90 national median wage to the $440 template build. Separate sections defend the wage and the benefits load, and build the 100-minute time estimate from a small timed trial, excluding patients' and facility staff time by viewpoint. A sensitivity section tests 80 and 120 minutes and a higher wage. A section names costs left out, including training. The last section explains that the program earns nothing under fee-for-service but may pay back under the episode model.
Where the points sit in the NR 517 Week 4 rubric
The rubric for the cost analysis usually rewards a clearly defined service, complete and appropriate cost components, credible sources, explicit assumptions and a thoughtful discussion of implications. Graders look closely at whether each figure has a source and whether assumptions are reasonable and stated. A sensitivity analysis, even a simple one, often earns credit under critical thinking. The implications criterion asks how the cost fits the organization's payment arrangements. Clear tables formatted in APA 7, organization and writing complete the grade. A paper with fewer numbers, each defended, typically outscores one with many unsourced figures, because the rubric is testing reasoning rather than arithmetic. Graders often recompute one line, so keep arithmetic visible.
NR 517 Week 4 help from the desk
The biggest mistake is presenting figures without sources or labels, which leaves the grader unable to judge them. Mark each number as sourced or assumed. Another is mixing viewpoints, counting patient time in one line and not another; choose the hospital's, the payer's or society's view and stay with it. Students also confuse cost with charge or reimbursement. Do not claim savings you have not estimated. Build uncertain estimates from parts, as the sample does with call time, and test them with a range. Finally, state what you left out and why. An honest exclusion list shows you understand the analysis, and it lets a reader add items back.
Get a NR 517 Week 4 example written to your instructions
Send the Week 4 instructions, plus any spreadsheet template or required categories your classroom publishes, and a custom cost write-up with its assumption register built out arrives inside 24 to 48 hours, the first one free. Name the service you want priced and we will keep the boundary tight around it.
More NR 517 papers and MSN samples
- NR 517 Week 1: Discussion Post Tracing One Bill
- NR 517 Week 2: Health System Map for One Episode
- NR 517 Week 3: Reimbursement Model Comparison
- NR 517 Week 5: Access and Coverage Brief
- NR 517 Week 6: Staffing Economics Case Study
- NR 517 Week 7: Policy Impact Analysis
- NR 517 Week 8: Delivery Reform Proposal
NR 517 Week 4 questions, answered
Where do I get cost figures if I do not work in finance?
Published sources carry more than students assume. Wage data by role and region, public cost reports, supply catalogs and manufacturer list prices will build a defensible estimate. Your employer's contracted rates and internal cost accounting are usually confidential and should stay out of a submitted paper. An estimate from public sources, clearly labeled as an estimate, is worth more marks than a real number you cannot cite.
What is the difference between cost, charge and reimbursement here?
Cost is what producing the service consumes. Charge is what appears on a bill before anybody negotiates. Reimbursement is what the payer actually releases. The three can differ by a wide margin for the same service, and a paper that swaps them mid-argument changes its own meaning without saying so. Define the one you are using in your opening paragraph and hold to it.
Does the paper need a spreadsheet attached?
Only if your section asks for one. Where it does, the file usually has to show formulas rather than typed results, because the point is that a reader can trace the arithmetic. Where it does not, a clean table inside the document does the same work. Either way the numbers in the prose and the numbers in the table have to agree, and graders check.
Where can I find a free NR 517 Week 4 sample paper?
The follow-up program costing shown above is a full NR 517 Week 4 paper, table and sensitivity range included, and it is free to read. If you need a service from your own unit costed, the request form will return a matching analysis.
Where do I get cost figures for the NR 517 cost analysis?
Use published sources where you can, such as the Bureau of Labor Statistics for wages, and label internal figures as assumptions. The sample uses a national median wage and states the benefits load and volumes as hospital assumptions.