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Researchers analysed more than 600,000 traditional Medicare hospitalisations around the suspension and reinstatement of the Medicare 'three‑day rule' and found the policy’s return on May 12, 2023 increased the share of stays lasting at least three nights without improving outcomes or lowering spending.
Using a regression‑discontinuity design comparing hospitalisations in the 28 days before and after reinstatement, the JAMA Internal Medicine study (published Feb. 9, 2026) found a 1.13 percentage‑point overall rise (60.4% to 62.0%) in stays of three or more nights and a 5.57‑point rise among patients discharged to skilled nursing facilities.
There were no significant changes in SNF use, total SNF days, 30‑day readmissions, 30‑day mortality or Medicare spending.
Subgroups with dementia and hip fractures saw larger increases.
Authors say the rule appears to have driven longer inpatient stays—adding at least 2,000 hospital days in the first month—and recommend reconsideration of the policy while noting limits to generalisability and potential confounding.
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Medical News | Medical ArticlesMedicare's three-day rule: Longer hospital stays, no patient benefit







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