Eliminating the three-day stay requirement for Medicare Advantage enrollees does not increase hospital or skilled nursing facility admissions or SNF lengths of stay, according to a new study published in Health Affairs. While traditional Medicare requires beneficiaries to be hospital inpatients for three days before it will cover their post-acute skilled nursing care, the policy is optional for Medicare Advantage plans. The study compared changes in use of hospital and SNF care among enrollees in MA plans that did and did not eliminate the requirement between 2006 and 2010. “These results suggest that Medicare Advantage plans may have realized cost savings by eliminating this precondition for Medicare payment,” the study concludes. “Investigation of the effects of waiving this requirement on the use of acute and post-acute care in [accountable care organizations] and traditional Medicare is warranted." Unlike ACOs, MA plans also have the option of controlling costs through coverage restrictions, the use of prior authorization, increased cost sharing, and enhanced limitations on the network of available providers, the authors note.

Related News Articles

Blog
Policymakers should provide a stable environment for post-acute care providers to implement existing reforms and evaluate their impact, writes Jim Prister, CEO…
Headline
The Centers for Medicare & Medicaid Services late today issued a final rule updating payment rates for skilled nursing facilities for fiscal year 2020.
Headline
The Centers for Medicare & Medicaid Services yesterday released a proposed rule that would revise certain requirements for long-term care facilities.
Perspective
America’s hospitals and health systems are committed to improving post-acute care — and patient outcomes — while ensuring changes to the system have the…
Headline
The Centers for Medicare & Medicaid Services today released its home health prospective payment system proposed rule for calendar year 2020.
Headline
The AHA today on Capitol Hill convened a panel of post-acute care leaders to brief lawmakers and their staff about the value these facilities provide to…