Medicare has long required a three-day hospital stay before it will pick up the tab for a senior to move into a skilled nursing facility. A new data crunch shows that waiving this prerequisite shortens costly and risky hospital stays—without driving up admissions to skilled nursing facilities or lengthening stays therein.
The insight arrives in the August issue of Health Affairs, in which five researchers from Brown and one from Harvard report on their analysis of 257,415 enrollees in Advantage, a set of Medicare plans that often end up waiving the three-day requirement.
Between 2006 and 2010, they found, average hospital stays were shorter than control cohorts by an average 0.2 days among 116,676 Medicare Advantage patients who received the waiver.
In the same time window, 140,739 patients who were in Advantage plans that never waived the requirement stayed in the hospital half a day longer.
Led by Regina Grebla, PhD, of Brown’s Center for Gerontology and Health Care Research, the authors suggest their findings point to likely savings to Medicare Advantage.
They add that the numbers may be predictive of shorter post-hospital recovery phases and lower risks of hospital-acquired infections and blood clots.
The study limitations they list include lack of information on each patient’s reason for hospitalization, which kept them from figuring out whether differences varied by diagnosis.
In their study discussion, Grebla and colleagues state that their findings may suggest the elimination of the three-day-stay requirement would “open the floodgates” for patients hoping to get into skilled nursing facilities.
“However, we did not observe an influx of skilled nursing facility admissions directly from home in case plans after they eliminated the requirement,” they write.
They recommend further studies exploring the impact of the waiver on use of hospital services and post-acute care among long-term residents of nursing homes.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.