Becker's Healthcare October 23, 2024
Kodiak Solutions said its analysis of hospital inpatient and outpatient claims data suggests that payers are “continuing to apply their own criteria for inpatient admission and dismissing the two-midnight rule for Medicare beneficiaries.”
The firm analyzed claims data from more than 1,900 hospitals between July 2023 and June 2024, according to the report. The analysis compares observation rates prior to and following the January 2024 implementation of the two-midnight rule for Medicare Advantage plans. Kodiak analyzed data for three health plan categories: commercial/managed care, Medicare Advantage and traditional Medicare.
The data shows that Medicare Advantage plans began classifying fewer observation stays starting in January, according to an Oct. 23 Kodiak news release. Observation rates for MA plans ranged between...
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