Waiving Medicare's 3-day rule lessens hospital stay

http://www.eurekalert.org/pub_releases/2015-08/bu-wmt072915.php

Public Release: 3-Aug-2015
Waiving Medicare's 3-day rule lessens hospital stay
Brown University

PROVIDENCE, R.I. [Brown University] -- For nearly 50 years Medicare has required patients to endure at least a three-day stint in the hospital before they become eligible for coverage of skilled nursing care afterward. A new study, however, finds that the main consequence of waiving the rule, as Medicare Advantage plans commonly do, has been a good one: less time in a bed and a gown for those who go on to skilled nursing care.

Specifically, the Brown University research team found that between 2006 and 2010 the average time in the hospital per year increased by half a day among 140,739 people in 14 plans that never waived the rule, but decreased by 0.2 days among 116,676 people in 14 otherwise similar plans after they waived it. That net difference of 0.7 fewer days on average in the hospital -- a 10 percent relative reduction -- likely saved Medicare Advantage plans money, but also meant less time before patients could move to the next phase in their recovery and less time when they were at risk of experiencing hospital-acquired complications, such as an infection or blood clot.

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Meanwhile, the researchers found no evidence of several potential negative consequences of waiving the rule: Did members of plans that waived the rule have more skilled nursing admissions? No. Were they in skilled care for longer? No.

The researchers also checked to see if patients in rule-waiving plans had more hospital admissions. They did not.

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