| Course | NR 717 Concepts in Population Health Outcomes & Health Policy |
|---|---|
| Week | 2 |
| Paper type | Population health analysis |
| Length | About 1,120 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | October 2026 |
Free sample paper for NR 717 Week 2
Postpartum Hypertension at Riverbend Health: A Population Health Analysis With the Spending Already Reaching the Population
Student Name
College of Nursing, Chamberlain University
NR 717: Concepts in Population Health Outcomes & Health Policy
Instructor Name
Month Day, Year
Postpartum Hypertension at Riverbend Health: A Population Health Analysis With the Spending Already Reaching the Population
The Population and Its Denominator
The population is every patient with a delivery hospitalization at Riverbend Health, a composite safety net system of three hospitals in a metropolitan county of 611,000 people, in the most recent complete fiscal year: 4,180 delivery hospitalizations. The denominator stays the same throughout this analysis. Where a subgroup is used, it is named and counted as a share of the 4,180, so every figure can be traced back to one cohort.
Payer mix shapes everything that follows. Medicaid financed 2,341 deliveries, 56.0%; commercial insurance financed 1,588, 38.0%; and 251, 6.0%, were self-pay or other. Of the cohort, 1,254 patients, 30.0%, identified as Black, and 1,714, 41.0%, lived in neighborhoods ranked in the most deprived two-fifths on the Area Deprivation Index.
Which Conditions Concentrate, and Where
Hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia, were recorded at discharge for 502 patients, 12.0% of the cohort. Another 209, 5.0%, had chronic hypertension before pregnancy. The burden is not even. Among Black patients, 199 of 1,254 had a hypertensive disorder, 15.9%, against 182 of 1,756 White patients, 10.4%. The direction matches national data, in which pregnancy-related deaths are about three times as common among Black women as among White women, with cardiovascular causes prominent among them (Petersen et al., 2019).
Why the Pattern Exists
Three determinants are doing most of the work, and none of them is a personal choice. The first is chronic hypertension entering pregnancy, which reflects years of care before conception, or its absence. The second is coverage: in the baseline year, before the state extended postpartum Medicaid to twelve months, only 73.0% of Medicaid-financed patients were still enrolled six months after delivery and 55.0% at twelve months. Coverage loss in the months around childbirth is common nationally (Daw et al., 2017), and a patient without coverage is unlikely to return for a blood pressure check. The third is access to the follow-up itself: on the system's social needs screen, 31% of Medicaid-financed patients with a hypertensive disorder reported that transportation would make a return visit difficult.
The Spending Layer
The money already reaching this population after delivery is substantial, and most of it is spent on the consequences of missed follow-up. In the 42 days after delivery discharge, the cohort made 418 emergency department visits and had 96 readmissions. Medicaid managed care plans paid for 271 of those visits at an average of $780, or $211,380, and for 61 of the readmissions at an average of $9,450, or $576,450. Thirty-one readmissions were for postpartum preeclampsia or severe hypertension; 21 of these were Medicaid-financed, at a cost to the plans of $198,450.
Table 1
Postpartum Utilization and Medicaid Spending, Riverbend Health, Baseline Year
| Use within 42 days of delivery discharge | All payers | Medicaid-financed | Average Medicaid payment | Medicaid spending |
|---|---|---|---|---|
| Emergency department visits | 418 | 271 | $780 | $211,380 |
| Readmissions, all causes | 96 | 61 | $9,450 | $576,450 |
| Readmissions for hypertension | 31 | 21 | $9,450 | $198,450 |
| Emergency visits for raised pressure or headache, sent home | 109 | 74 | $780 | $57,720 |
Note. Note. Hypertension readmissions and the last row are subsets of the rows above them. Payments are average managed care plan payments to the system.
Avoidable Use, Separated Out
Not all of this spending is avoidable, and treating it as a single total would overstate what any program could save. Two categories are plausibly avoidable with timely blood pressure monitoring: the 109 emergency department visits for raised blood pressure or headache that ended with discharge home, and the 31 readmissions for hypertension. The first group is care in the wrong place, a blood pressure check delivered in the most expensive setting available. The second includes some admissions that earlier detection might have prevented and some that it would not. The remaining 309 emergency visits and 65 readmissions, for wound problems, infection, bleeding and other causes, are necessary care that blood pressure monitoring would not touch.
A Benchmark, Named
The state perinatal quality collaborative's 2025 member report gives a median blood pressure check rate within 7 to 10 days of 52% for patients with hypertensive disorders, across its member hospitals. Riverbend's rate was 39.0%, 196 of 502. Its postpartum visit rate among Medicaid-financed patients, 62.0%, also sits below the collaborative's median of 68%. Both comparisons are against hospitals in the same state, under the same Medicaid program, which makes them fairer than national figures.
Where Money Currently Buys Nothing
Some current spending buys no improvement in this outcome. The six-week postpartum visit is paid for, but it falls well after the window in which postpartum preeclampsia most often presents, so a patient whose pressure rises on day five is not helped by an appointment on day forty-two. And emergency visits for raised pressure that end with a patient sent home without a plan for repeat checks pay for a reading, not for follow-up. These are the places where redirected money would do the most. Neither requires new money to identify; both show up in records the system already keeps, which is where any proposal to redirect spending should begin.
Limits of the Analysis
Three limits apply. The utilization counts come from Riverbend's own records, so visits and admissions at other hospitals in the county are missed, and the true use is higher. Medicaid payments are averages across the system's two largest managed care contracts and may not match what a smaller plan pays. And the year analyzed is the last one before the state's twelve-month postpartum coverage took effect, so the coverage figures describe a situation that has already begun to change. The analysis should be repeated on the first full year under extended coverage before anyone uses these figures to estimate future spending. The findings point the same way whatever these limits do; each makes the true figures somewhat larger or less certain.
What the Analysis Implies
The population carries a concentrated, unequal burden of postpartum hypertension, the payers already spend about $256,000 a year on avoidable use linked to it among Medicaid members alone, and the current pattern of care pays for late visits and emergency readings rather than for timely checks. Medicaid expansion in other states has been followed by gains in postpartum coverage and outpatient care (Gordon et al., 2020), which suggests that coverage changes can move the follow-up this population is missing, if the care itself is designed to reach patients in the first ten days.
References
Daw, J. R., Hatfield, L. A., Swartz, K., & Sommers, B. D. (2017). Women in the United States experience high rates of coverage churn in months before and after childbirth. Health Affairs, 36(4), 598-606. https://doi.org/10.1377/hlthaff.2016.1241
Gordon, S. H., Sommers, B. D., Wilson, I. B., & Trivedi, A. N. (2020). Effects of Medicaid expansion on postpartum coverage and outpatient utilization. Health Affairs, 39(1), 77-84. https://doi.org/10.1377/hlthaff.2019.00547
Petersen, E. E., Davis, N. L., Goodman, D., Cox, S., Syverson, C., Seed, K., Shapiro-Mendoza, C., Callaghan, W. M., & Barfield, W. (2019). Racial/ethnic disparities in pregnancy-related deaths: United States, 2007-2016. MMWR. Morbidity and Mortality Weekly Report, 68(35), 762-765. https://doi.org/10.15585/mmwr.mm6835a3
What the NR 717 Week 2 assignment asks for
Build the analysis in two layers. The first describes the population: who they are, where they live, which conditions concentrate among them and which determinants are doing the work, stated as measured shares rather than as individual choices. The second describes the money already reaching them, which is what makes the analysis doctoral. Hold a single denominator from start to finish, and express each subgroup against it, so figures can be compared across sections. Examine utilization as expenditure, not just volume: say what emergency visits, readmissions and avoidable admissions cost and who paid. Separate avoidable use from necessary care rather than reporting one total. Compare your figures with a benchmark you name outright, ideally one from a similar setting. Identify where current spending buys nothing, state the limits of your data and close with what the analysis implies.
Inside the NR 717 Week 2 example
The sample states its single cohort and payer mix, then shows hypertensive disorders concentrated among Black patients and in deprived neighborhoods, citing national data on pregnancy-related deaths. Three determinants are tied to local shares: chronic hypertension before pregnancy, only 73.0% of Medicaid patients still enrolled at six months and 31% reporting transport barriers. The spending layer reports 418 emergency visits and 96 readmissions within 42 days, with a table of Medicaid payments. Two categories are separated as plausibly avoidable: 109 emergency visits for raised pressure ending with discharge home and 31 hypertension readmissions. A state collaborative median of 52% is set against Riverbend's 39.0%. The paper notes that the six-week visit falls after the danger window, lists three data limits and closes on coverage and timing.
Reading the NR 717 Week 2 grading rubric
The heaviest loss is a profile with no money in it, a competent description any public health course would accept and that gives a doctoral rubric nothing extra to reward. Next is utilization reported as volume, so a readmission rate appears and nobody learns what it cost or who paid. Marks are also lost when the denominator shifts between sections, when determinants are attributed to individual choice, when benchmarks are implied rather than named and when avoidable and necessary care are merged into one total. Graders take points for sources from mismatched years. Analyses score well when the spending layer sits directly over the population layer and when the paper shows where current money buys nothing.
NR 717 Week 2 help: mistakes that cost points
Finding the spending layer is usually the hardest part, because cost data sit in places nurses rarely look. Tell us your population and the data you can reach, such as claims summaries, payer reports or hospital cost accounting, and we can help you keep one denominator, convert utilization into spending, separate avoidable from necessary use and choose a fair benchmark. We can also help you write the section on where money currently buys nothing. The population, the data and the conclusions belong to your own setting.
Get a NR 717 Week 2 example written to your instructions
Send the Week 2 instructions with the element list and the population your section assigned or you selected yourself, and a custom example is written to those requirements and returned inside 24 to 48 hours. The first one is free. Which population you carry through the term is your own decision to make.
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NR 717 Week 2 questions, answered
Where does cost data for a population come from?
Published claims analyses, state all payer databases where a state maintains one, hospital community benefit reporting and national utilization surveys all serve at this level. What matters more than the source is that the year, the payer and the covered population are stated, because a per member figure from one payer cannot be applied to a whole community without saying openly that you have done it.
How is this different from a community needs assessment?
A needs assessment asks what a population lacks. This asks what is already being spent on them and what that spending produces, which is a question about efficiency as much as about need. The two draw on overlapping data and diverge completely in their conclusions, and a paper submitted here that only establishes need has answered the other question instead.
Does the analysis have to include an intervention?
Usually not yet, and reaching for one early tends to weaken the paper. This assignment exists to establish where the mismatch sits so that later work has something to aim at. Where your section does ask for a preliminary recommendation, keep it proportionate to what the data actually showed rather than to how serious the problem feels while you are writing about it.
Where can I find a free NR 717 Week 2 sample paper?
A complete population health analysis of postpartum hypertension at a safety net system, with its spending layer, is on this page.
Why does the NR 717 Week 2 sample separate avoidable use from the total?
Most postpartum emergency visits and readmissions are for causes blood pressure monitoring would never touch, so only 109 visits and 31 readmissions are counted as avoidable.