How shortening skilled nursing facility stays might identify waste in health care delivery

A Health Podyssey

Skilled nursing care is an important Medicare benefit but it also accounts for significant spending.

In Medicare, cost sharing applies to patients' care in skilled nursing facilities after the twentieth day of residence. This prompts a spike in discharges from facilities at that time. But does cutting short these skilled nursing facility stays at day 20 negatively impact patient health?

J. Michael McWilliams, a researcher from Harvard Medical School and Brigham and Women's Hospital, and coauthors aimed to answer this question in a paper they published in the May 2021 issue of Health Affairs. They studied the extent to which skilled nursing facility discharges accelerated by Medicare cost sharing are safe.

McWilliams and coauthors found no clear evidence that those who are discharged face increased risk of death, hospitalization for fall-related injuries, or all-cause hospitalizations.

On this episode of A Health Podyssey, J. Michael McWilliams joins Health Affairs Editor-in-Chief Alan Weil to discuss this research and his perspective on the future of health care financing.

Pre-order the July 2021 Health Affairs issue.

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