Fortune March 30, 2024
When a clinician admits a Medicare beneficiary for inpatient care, their choice may have been influenced by a Centers for Medicare and Medicaid Services (CMS) standard that sounds like a term from a spy novel: the two-midnight rule.
The two-midnight rule is used when a clinician believes that a Medicare beneficiary needs hospital care that will likely eclipse two midnights—requiring inpatient care instead of cheaper outpatient care, Regan Tankersley, an attorney at the law firm Hall Render who advises healthcare systems, told Healthcare Brew.
“It’s a more expensive setting, it’s more expensive care, and so it costs more for the payer,” she said.
CMS first implemented the two-midnight rule in 2013 to provide hospitals with a benchmark on what types...
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