| Course | HCS 499 Health Care Strategy Capstone (HCS/499) |
|---|---|
| Week | 5 |
| Paper type | Strategic plan application and scenario analysis |
| Length | about 1,007 words, 4 double-spaced pages plus title page and references |
| Format | APA 7 student paper |
| School | University of Phoenix |
| Program | BS in Health Administration |
| Updated | September 2026 |
Free sample paper for HCS 499 Week 5
Planning for a Hospice Market That Will Not Stand Still: Testing a Community Hospice's Strategic Plan Against Three Futures and Building in the Ability to Change Course
[Student Name]
University of Phoenix
HCS/499: Health Care Strategy Capstone
Week 5 Assignment
[Instructor Name]
[Date]
The hospice, its plan and its scenarios are composites written for a model paper; industry findings come from the sources listed.
Over four weeks, the capstone built a strategic plan for a 40-year-old nonprofit community hospice: a revised mission, a vision centered on timely referral and a stable team, a SWOT analysis and three priorities with nine SMART objectives. A plan written today will be carried out in a market that will look different in three years. This paper identifies the forces shaping hospice care, tests the plan against three possible futures and builds in ways to change course.
Four Forces
Rising use and more providers. Federal payment advisers count a majority of Medicare decedents now using hospice and a one-year jump of more than a tenth in the number of hospices, most of it from for-profit newcomers (Medicare Payment Advisory Commission, 2025). Demand is rising, and so is competition for it.
Investor ownership. Braun et al. (2021) showed investor-owned buyers, both private equity funds and public companies, purchasing hospice agencies at a growing pace over the past decade. Larger, well-capitalized owners bring marketing, technology and purchasing power that small nonprofits lack.
Medicare Advantage. Hospice has been paid through traditional Medicare even for Medicare Advantage enrollees. Stevenson and Huskamp (2014) examined the case for integrating hospice into Medicare Advantage, arguing that it could improve coordination at the end of life but raising concerns about access and plan incentives. A federal model testing inclusion of hospice in Medicare Advantage plans ended in 2024, but the question is likely to return, and if hospice were carved in, plans would choose networks and negotiate rates.
Workforce. Kamal et al. (2017) projected that the supply of palliative care specialists would fall further behind need, and hospices nationwide are short of nurses and aides as well.
Technology and the Future
Technology will also shape hospice care. Remote symptom monitoring and video visits can extend nurses' reach, especially in rural areas, and could ease the workforce shortage if used carefully. Competitors with larger budgets will adopt these tools first. The plan's workforce priority should therefore include a pilot of video visits for routine follow-up and after-hours triage in year two, measured by family satisfaction and nurse drive time saved.
Scenario 1: Steady Growth
Demand keeps rising, competition stabilizes and payment rules change little. In this future the plan holds well. The workforce priority remains the constraint on growth, and the palliative program expands. The main risk is complacency; the hospice should keep its objectives on schedule.
Scenario 2: Consolidation
Two of the four new competitors are bought by a national chain that invests heavily in physician marketing and same-day admissions. Referrals shift toward the chain. In this future, priority 2 becomes urgent: the hospital partnership and palliative program are the hospice's best defense, because they create referral paths that marketing cannot easily replace. The hospice should speed up its physician liaison hiring and publish its family survey results widely.
Scenario 3: Medicare Advantage Carve-In
Congress or federal regulators include hospice in Medicare Advantage. Plans form networks and negotiate rates. In this future, the hospice's survival depends on being in the networks of the two plans that enroll most of its counties' older adults, so quality data, a record of lower hospital use at the end of life and the palliative program become bargaining assets rather than simply good care. The hospice would need contracting expertise it lacks today and might need to affiliate with other nonprofits to negotiate together.
What Holds in Every Future
The workforce priority matters in all three scenarios: without nurses and aides, the hospice cannot grow, compete or contract. Earlier referral through palliative care matters in all three as well. The inpatient house is the most exposed: in a consolidation or carve-in future, its losses become harder to fund. That finding tells the board where flexibility is most needed.
What the Board Must Do Differently
Scenario thinking changes how a board works. Instead of approving the plan once and reviewing results annually, the board will spend part of each quarterly meeting on the indicators and ask whether any scenario is becoming more likely. It will also authorize the chief executive in advance to take certain contingency steps, such as opening talks with other nonprofit hospices, so that the organization can move quickly when an indicator crosses its threshold rather than waiting for the next meeting. The board will also review the scenarios themselves each year and replace any that no longer seem plausible.
Early Warning Indicators and Contingency Moves
The board will watch five indicators each quarter: the share of referrals from the regional hospital system, admissions lost to competitors by referral source, nurse vacancy rate, federal and state policy on hospice in Medicare Advantage and the house's occupancy. If hospital referrals fall by more than 15%, the hospice will escalate partnership talks and consider a formal affiliation. If a carve-in is proposed in regulation, it will begin network contracting preparations and talks with other nonprofit hospices about a joint contracting entity. If house occupancy stays below 68% after year one, it will reduce the house to eight beds.
The Capstone Plan on One Page
Mission: comfort, dignity and support for seriously ill and dying people across the three counties, at home or in the hospice house. Vision for 2030: early referral for everyone who could benefit and a team nurses and aides choose. Key strengths: community trust, quality, volunteers. Key weaknesses: workforce, late referrals, house finances. Priorities: workforce, earlier referral, a sustainable house. Objectives: nine SMART objectives with owners and budgets. Future: scenario-tested, with five indicators and contingency moves reviewed quarterly.
Conclusion
No plan predicts the future, but a good one can survive several. Testing the hospice's plan against steady growth, consolidation and a Medicare Advantage carve-in shows that its workforce and early referral priorities hold in every case, while the inpatient house needs the most flexibility. With indicators and contingencies in place, the plan can change course without losing its purpose.
References
Braun, R. T., Stevenson, D. G., & Unruh, M. A. (2021). Acquisitions of hospice agencies by private equity firms and publicly traded corporations. JAMA Internal Medicine, 181(8), 1113-1114. https://doi.org/10.1001/jamainternmed.2020.6262
Kamal, A. H., Bull, J. H., Swetz, K. M., Wolf, S. P., Shanafelt, T. D., & Myers, E. R. (2017). Future of the palliative care workforce: Preview to an impending crisis. The American Journal of Medicine, 130(2), 113-114. https://doi.org/10.1016/j.amjmed.2016.08.046
Medicare Payment Advisory Commission. (2025). Report to the Congress: Medicare payment policy, Chapter 9: Hospice services. https://www.medpac.gov/wp-content/uploads/2025/03/Mar25_Ch9_MedPAC_Report_To_Congress_SEC.pdf
Stevenson, D. G., & Huskamp, H. A. (2014). Integrating care at the end of life: Should Medicare Advantage include hospice? JAMA, 311(15), 1493-1494. https://doi.org/10.1001/jama.2014.1018
What the HCS 499 Week 5 instructions ask
The final HCS 499 assignment usually asks students to apply their strategic plan to the future of health care. Prompts may ask students to identify trends likely to affect the organization, such as payment reform, technology, demographics, workforce and competition, explain how the plan addresses them, and describe how the organization will monitor and adapt the plan. Some sections ask for a presentation of the complete plan or an executive summary. About three pages is common, sometimes with slides. Strong papers go beyond listing trends: they test the plan against specific futures, identify what would signal that conditions are changing and set out what the organization would do in response, while summarizing the plan built across the capstone.
How this HCS 499 Week 5 example is built
The sample begins by restating the plan's three priorities so the reader can follow the test. It then names four forces with evidence: growth in hospice use and providers from federal payment advisory data, investor ownership from research on hospice acquisitions, the debate over folding hospice into Medicare Advantage, and the palliative care workforce shortage. Three scenarios combine these forces into different futures: steady growth, consolidation and a Medicare Advantage carve-in. For each, the paper shows which priorities hold, which need adjustment and what the hospice would do. Early warning indicators and contingency moves follow. A one-page summary of the entire capstone, from mission to objectives, closes the paper as a board-ready document.
HCS 499 Week 5 grading rubric: where the points go
For the capstone's last week, rubrics usually reward forward-looking analysis tied to the plan. Faculty look for trends supported with current evidence, a clear explanation of how each affects the organization, and a test of the plan against those trends rather than a list. Scenario thinking, indicators and contingency plans earn credit because they show adaptability. A coherent summary of the full plan is often graded as evidence that the capstone fits together. Clear organization and correct citations complete the score. Papers that describe the future of health care in general terms without returning to the organization's plan tend to lose points.
HCS 499 Week 5 help: mistakes to avoid
Many HCS 499 Week 5 drafts go wrong by writing a general essay on the future of health care that never mentions the organization's plan. Every trend should lead back to a priority or objective. Another is predicting one future with confidence; scenarios are more honest and more useful. Choose indicators the organization can actually watch, such as referral volumes or state policy changes. Include what the organization would do if an indicator moves, since adaptability is the point. Use current evidence for each trend. Finally, include a concise summary of the whole plan, because many instructors grade this week as the capstone's final product, and a reader should be able to see mission, analysis, goals and future in one place.
Related HCS 499 sample papers
Other HCS 499 week samples
- HCS 499 Week 1: Strategic Planning in Health Care
- HCS 499 Week 2: Mission and Vision
- HCS 499 Week 3: SWOT Analysis
- HCS 499 Week 4: Creating Goals and Objectives
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HCS 499 Week 5 questions, answered
What does HCS/499 Week 5 usually ask for?
Many sections ask students to apply their strategic plan to the future of health care, explaining how trends will affect the organization and how the plan will be monitored and adapted, often with a summary of the whole plan.
Where can I find a free HCS 499 Week 5 sample paper?
The scenario-tested hospice plan above is the free final sample in this capstone thread, complete with margin notes. A first custom paper for your own organization's future can be ordered at no cost.
What is scenario planning?
A method of preparing for uncertainty by describing several plausible futures, testing a strategy against each and identifying signals and responses, instead of betting on a single forecast.
What trends are shaping hospice care?
Rising use of hospice, rapid growth in providers, increasing ownership by private equity and public companies, debates over including hospice in Medicare Advantage and shortages of nurses, aides and palliative specialists.
What is an early warning indicator in strategic planning?
A measurable signal, such as a drop in referrals from a key partner or a policy change, that tells leaders conditions are shifting and a contingency plan may be needed.
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