ArticleHealth affairs (Project Hope)2015
Waiving the three-day rule: admissions and length-of-stay at hospitals and skilled nursing facilities did not increase.
Article in Health affairs (Project Hope), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed.
- Algorithmic Identification of the Daily Primary Frontline Clinician during Inpatient Medicine Encounters Using EHR Audit Log Data.Applied clinical informatics · 2026Article
- Changes in Inpatient and Skilled Nursing Facility Care After the Medicare 3-Day Rule Reinstatement.JAMA internal medicine · 2026Article
- Low-Energy Pelvic Ring Fractures: A Care Conundrum.Geriatric orthopaedic surgery & rehabilitation · 2021Article
- Long-Term Care, Residential Facilities, and COVID-19: An Overview of Federal and State Policy Responses.Journal of the American Medical Directors Association · 2020Article
- Improving Healthcare Value: COVID-19 Emergency Regulatory Relief and Implications for Post-Acute Skilled Nursing Facility Care.Journal of hospital medicine · 2020Article
- Policy in Clinical Practice: Medicare Advantage and Observation Hospitalizations.Journal of hospital medicine · 2020Article
- Beta-Blocker Use in U.S. Nursing Home Residents After Myocardial Infarction: A National Study.Journal of the American Geriatrics Society · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
The traditional Medicare program requires an enrollee to have a hospital stay of at least three consecutive calendar days to qualify for coverage of subsequent postacute care in a skilled nursing facility. This long-standing policy, implemented to discourage premature discharges from hospitals, might now be inappropriately lengthening hospital stays for patients who could be transferred sooner. To assess the implications of eliminating the three-day qualifying stay requirement, we compared hospital and postacute skilled nursing facility utilization among Medicare Advantage enrollees in matched plans that did or did not eliminate that requirement in 2006-10. Among hospitalized enrollees with a skilled nursing facility admission, the mean hospital length-of-stay declined from 6.9 days to 6.7 days for those no longer subject to the qualifying stay but increased from 6.1 to 6.6 days among those still subject to it, for a net decline of 0.7 day when the three-day stay requirement was eliminated. The elimination was not associated with more hospital or skilled nursing facility admissions or with longer lengths-of-stay in a skilled nursing facility. These findings suggest that eliminating the three-day stay requirement conferred savings on Medicare Advantage plans and that study of the requirement in traditional Medicare plans is warranted.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.