Amid increasing evidence that prior authorization and denials in Medicare Advantage (MA) may delay access to nursing homes, a new study shows that MA patients often experience longer hospital stays before discharge to a post-acute care setting, compared to those with traditional Medicare.

This is according to a June study by NORC at the University of Chicago, which examined Medicare claims data as well as MA encounter records from 2018 to 2022, focusing on discharges to post-acute settings such as home health agencies, skilled nursing facilities, inpatient rehabilitation, and long-term acute care hospitals.

Between this period, MA hospital discharges to PAC increased by 5.6% from 338 to 357 beneficiaries per 1,000 discharges. Meanwhile, Medicare hospital discharges, however, decreased by 1.5% from 401 to 395 per 1,000 discharges.

Moreover, MA patients consistently had longer hospital stays before transitioning to post-acute care, with the median length of stay in 2022 being seven days for MA versus five days for traditional Medicare.

The disparity in hospital stay length widened over time. In 2022, MA enrollees had longer pre-discharge stays across all four post-acute settings, with hospital stays before discharge to skilled nursing facilities (SNFs) averaging nine days for MA, compared to six days for traditional Medicare.

Also, MA plans more frequently discharged patients to lower-acuity settings like home health agencies. In 2022, MA enrollees were 12.4% more likely than Medicare beneficiaries to be discharged to home health care. In contrast, traditional Medicare discharged patients to higher acuity settings such as SNFs more often than MA plans.

The study was commissioned by the Coalition to Strengthen America’s Healthcare, which represents more than 5,000 hospitals, businesses and hospital associations that includes the AHA and FAH.