NURS 6241 Week 2 Environmental Scan Example

Course	NURS 6241 Strategic Planning in Healthcare Organizations
Week	Week 2
Paper type	Environmental scan
Length	About 1,000 words, 6 pages
Format	APA 7 student paper
School	Walden University
Program	Master of Science in Nursing (MSN)
Updated	October 2026

Free sample paper for NURS 6241 Week 2

Environmental Scan: Six External Pressures on a Regional Health System in Allen County, Indiana

Student Name

College of Nursing, Walden University

NURS 6241: Strategic Planning in Healthcare Organizations

Instructor Name

Month Day, Year

What this page is doingThe title fixes the organization and its market, which is the boundary every later claim has to stay inside.

Environmental Scan: Six External Pressures on a Regional Health System in Allen County, Indiana

Scope

This scan covers a composite two-hospital regional health system based in Fort Wayne, serving Allen County, Indiana, and draws on public evidence available as of September 2026 about conditions expected through 2028. The system is composite; the county data, federal rules and national surveys are real. Six external pressures are described under plain headings. Each paragraph presents the evidence and closes with what it implies for this system. The scan proposes no strategy, which belongs to later work. Where evidence is national rather than local, the paragraph says so, so a reader can judge how far it applies to this county.

Reimbursement

Medicare pays for the system's hospital admissions through a prospective payment system whose annual update sets the ceiling on price growth for a large share of revenue. For fiscal year 2027, which began October 1, 2026, the Centers for Medicare & Medicaid Services estimated the hospital market basket, the growth in input prices, at 3.2% and reduced it by a 0.9 percentage point productivity adjustment, for a net update of 2.3% for hospitals that report quality data and are meaningful users of electronic health records (Medicare Program; Hospital Inpatient Prospective Payment Systems, 91 Fed. Reg. 49570, 2026). The same federal budget law discussed under regulation also limits Medicaid financing that supports hospitals. It lowers the threshold for state provider taxes in fiscal years beginning on or after October 1, 2026, and caps new state directed payments in Medicaid expansion states at 100% of the Medicare rate (Pub. L. No. 119-21, 2025). Indiana covers the expansion population. Implication for this system: Medicare price growth will trail input cost growth whenever wages rise faster than the market basket forecast, and Medicaid supplemental payments that the system may rely on face new federal limits, so the margin on public-payer volume is likely to narrow through 2028.

Workforce Supply

A 2024 national survey of the nursing workforce estimated that more than 138,000 nurses had left the workforce since 2022 and that almost 40% of nurses intended to leave by 2029 (Smiley et al., 2025). The survey is national, so it does not show conditions in Allen County, but its findings describe the labor pool from which the system recruits. Implication for this system: vacancy and agency costs are likely to remain a pressure, and any plan that expands services must account for the nurses it would need to hire and keep.

Population Change

Allen County had an estimated 399,295 residents in 2024. Of these, 65,095, or 16.3%, were aged 65 or older, and another 44,080, or 11.0%, were aged 55 to 64 and will reach Medicare age within the next decade (U.S. Census Bureau, 2025). Among county residents aged 19 to 64, about 17.6% had Medicaid or other means-tested public coverage. Implication for this system: demand for services used by older adults, including cardiac, orthopedic and post-acute care, will grow as the 55 to 64 group ages, and a larger share of volume will be paid at Medicare rates.

Regulation

The federal budget law enacted July 4, 2025, requires states to apply community engagement requirements to many adults in the Medicaid expansion group, beginning no later than the first quarter after December 31, 2026. An adult generally meets the requirement in a month by working, volunteering or joining a work program for at least 80 hours, by enrolling in school at least half-time, or by earning at least 80 times the federal minimum wage; the law also requires more frequent eligibility redeterminations for this group (Pub. L. No. 119-21, 2025). With about 40,000 county residents aged 19 to 64 holding Medicaid or similar coverage, a share of the system's current Medicaid patients may lose coverage for administrative or work-related reasons. Implication for this system: self-pay and uncompensated care are likely to rise from 2027, and patients who lose coverage may delay care and arrive sicker.

Technology

Virtual nursing, in which a remote nurse handles admissions, discharge teaching and mentoring by video, is spreading across inpatient care as systems respond to workforce and financial pressures. A 2026 scoping review of 36 sources found that its effects have been measured with 78 different metrics, fewer than half clearly defined, so the evidence for particular outcomes remains inconsistent (Cox et al., 2026). Implication for this system: competitors and staff will expect the system to consider virtual models, but the published evidence will not predict local results, so any adoption would need its own evaluation.

Competitor Movement

For calendar year 2026, Medicare began phasing out the list of procedures it pays for only in the inpatient setting over three years, removing 285 mostly musculoskeletal services in the first year, and added 276 procedures to the list payable in ambulatory surgery centers under revised criteria, plus 271 codes coming off the inpatient-only list (Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems, 90 Fed. Reg. 53448, 2025). Independent and physician-owned surgery centers in the county can therefore compete for Medicare cases that previously required a hospital. Implication for this system: its orthopedic and surgical volume, among its better-paid services, is exposed to migration to lower-cost outpatient competitors.

Ranking by Urgency

Table 1 orders the six pressures by how soon each affects the system's operations.

Table 1

External Pressures Ranked by Time to Effect

Rank	Pressure	When it bites	Basis
1	Reimbursement	Now (fiscal year 2027 rates in effect)	Net Medicare update of 2.3%; Medicaid financing limits from October 2026
2	Regulation	January 2027 onward	Community engagement and redetermination requirements
3	Workforce supply	Ongoing	National exits and intent to leave by 2029
4	Competitor movement	2026 to 2028	Inpatient-only list phase-out; expanded outpatient surgery list
5	Population change	Gradual, through 2035	11.0% of residents aged 55 to 64
6	Technology	Discretionary	Virtual nursing expanding; evidence inconsistent

What this page is doingRanking reflects time to effect, not size of effect. Population change is slowest but may be the largest over a decade.

The strategy work that follows should answer the reimbursement pressure first, since it is already in effect and it shapes what the system can afford to do about the other five.

References

An Act to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14, Pub. L. No. 119-21, 139 Stat. 72 (2025).

Cox, K., Watson, H., & Whalen, M. (2026). Measuring the impact of virtual nursing in inpatient care: A scoping review. Nursing Outlook, 74(3), Article 102751. https://doi.org/10.1016/j.outlook.2026.102751

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates, 91 Fed. Reg. 49570 (August 4, 2026).

Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems, 90 Fed. Reg. 53448 (November 25, 2025).

Smiley, R. A., Kaminski-Ozturk, N., Reid, M., Burwell, P., Oliveira, C. M., Shobo, Y., Allgeyer, R. L., Zhong, E., O'Hara, C., Volk, A., & Martin, B. (2025). The 2024 National Nursing Workforce Survey. Journal of Nursing Regulation, 16(1), S1-S88. https://doi.org/10.1016/S2155-8256(25)00047-X

U.S. Census Bureau. (2025). Sex by age (Table B01001) and Medicaid/means-tested public coverage by sex by age (Table C27007): Allen County, Indiana [American Community Survey 1-year estimates, 2024]. https://data.census.gov/

What the NURS 6241 Week 2 instructions ask for

Week 2 of NURS 6241 has students survey forces outside an organization that will shape its plan. Cover several categories, source each with current data, explain the effect on the organization and rank the forces. Breadth, sourcing and relevance are scored separately, so a scan with good sources but no link to the organization loses points. Cite public data and strategy texts in APA 7 with retrieval dates. Five or six forces is a common range. A scan looks outward only, while a SWOT adds internal strengths and weaknesses. The organization you work for can be scanned with care for confidentiality. A table with each force, its evidence, its likely effect and its urgency rank makes the scan easy to read. Keep each force to a paragraph or two and avoid repeating the same data under two headings.

How this NURS 6241 Week 2 example is built

The scan opens with a boundary sentence naming the organization, the market it sits in and the period its evidence covers, so a reader knows what was inside the frame. Six pressures follow under plain headings: reimbursement, workforce supply, population change, regulation, technology and competitor movement. Each runs to a short paragraph closing on a sentence that begins with the implication for this organization. Every factual claim carries a citation, and the sources are public ones a reader could open, among them federal payment rules, the federal budget statute, Census Bureau survey estimates and a national nursing workforce survey. A final page ranks the six by how soon each one bites. No grid, no mission statement and no proposal appear, and their absence is deliberate.

Reading the NURS 6241 Week 2 rubric

Rubrics for a scan tend to score breadth, sourcing and relevance on separate rows, and the example is arranged so each row has somewhere to look. Breadth shows in six headings. Sourcing shows inline. Relevance is the implication sentence, and it is the row most submissions surrender, because a scan reporting national trends with no word on their meaning for this organization has answered a general question rather than the assigned one. Points also drain toward vendor blogs and undated pages where a payment rule, a filing or a public dataset was available for the same claim. Where a rubric names currency, anything much older than five years needs its reason stated in the sentence that cites it.

Common NURS 6241 Week 2 mistakes, and how to avoid them

Environmental scans score poorly when they describe national trends with no local tie. Bring each force to the county. A second weakness is undated evidence. Give the year. Writers also skip ranking. Rank by urgency and explain why. Avoid internal items such as staff morale. Keep the scan external. Use real public data where it exists and label the composite. A one-line effect under each force, such as the share of revenue at risk, shows relevance. Close with the force the plan must answer first. Give every number its year and a findable source.

Get a NURS 6241 Week 2 example written to your instructions

Send the Week 2 prompt, the rubric, and the type of organization you are scanning: rural critical access, urban academic, a multi site medical group. A scan comes back fitted to that setting with its sources listed, so you can swap in the ones your own region publishes. First sample is free and returns inside 24-48 hours.

More NURS 6241 papers and MSN samples

NURS 6241 Week 2 questions, answered

Can the desk scan the organization I work for?

It can build the scan around the type of organization you name, and that is where the line runs. Board packets, budget files, quality dashboards and any other material your employer holds belong to your employer and are never reconstructed here. Give us the setting, the market and the service lines, and the sample arrives on public evidence you can then replace with the internal material only you can see.

How many forces should a scan cover?

Six is what this example uses, enough to look thorough without turning into a survey of everything happening in healthcare. Some prompts name the categories outright and some leave the count open. Where it is open, the useful test is whether a force could plausibly change a decision inside a year. A pressure that changes nothing is padding, and a grader reading for relevance treats it as padding.

Is a SWOT the same thing as a scan?

No, and merging the two is a reliable way to lose points here. A scan gathers what sits outside the organization and stops. A SWOT sets internal capability against that outside picture and normally arrives as its own later assignment. Strengths and weaknesses stay out of this example entirely, which is what lets a reader argue with the evidence without having to argue with a conclusion.

Where can I find a free NURS 6241 Week 2 sample paper?

The Allen County environmental scan is on this page with six external pressures, dated sources and the urgency ranking.

Which pressure ranks first in NURS 6241 Week 2?

The scan ranks the six by urgency for the planning cycle and explains each rank, so the reader sees which force the plan must answer first.