'Medicare 3-day rule adds extra costs for hospitals'

 Medicare’s 3-day rule adds costs to hospitals and does not lower Medicare spending on hospitalized patients, a study from researchers at Providence, R.I.-based Brown University found.

On May 12, 2023, the Medicare program reinstated a long-standing 3-day hospitalization rule for skilled nursing facility care, which had previously been waived for two years of the COVID-19 pandemic. The rule was established 1965 to manage the use of SNFs. Known as the 3-day rule, it requires patients to spend at least three consecutive days in the hospital before Medicare will cover care in a nursing facility. Medicare pays an average of about $15,000 for each stay, and 1 in 5 Medicare beneficiaries use SNF post-hospitalization.

The study, published Feb. 9 in JAMA Internal Medicine, used data from more than 600,000 traditional Medicare hospitalizations from January to November 2023. 

Here are four key findings:

1. The reinstated rule was associated with a 1.13 percentage point increase in the likelihood of an inpatient stay lasting at least three days.

2. Among patients discharged to SNF, there was a 5.57 percentage point increased probability of at least a three-day hospitalization. 

3. There were high three-day hospital stays among patients who were admitted for hip fractures and patients with dementia.

4. There were no significant changes in the overall probability of SNF discharge, 30-day rehospitalization, 30-day mortality, Medicare spending or total SNF days. 

“These findings suggest that the policy imposes additional costs on hospitals while failing to lower Medicare spending on hospitalized patients,” the study authors wrote. “More generally, results raise questions regarding the value and continued relevance of a broadly applicable 3-day inpatient stay rule in the traditional Medicare program.”

https://www.beckershospitalreview.com/post-acute/medicare-3-day-rule-adds-extra-costs-for-hospitals-4-study-notes/