Research Results from Brown University School of Public Health Update Knowledge of Managed Care (Extended Hospital Stays in Medicare Advantage and Traditional Medicare): Managed Care

2025 SEP 22 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on Managed Care have been published. According to news reporting originating in Providence, Rhode Island, by NewsRx journalists, research stated, “Hospitals have reported growing difficulty in discharging patients in a timely manner, often citing bottlenecks in postacute care. Medicare Advantage plans, now the dominant form of Medicare coverage, may contribute to these delays due to administrative and network constraints, yet national evidence is lacking.”

The news reporters obtained a quote from the research from the Brown University School of Public Health, “To quantify changes in hospital length of stay for Medicare Advantage vs traditional Medicare beneficiaries. This retrospective cohort study used Medicare claims from 2017 through the third quarter of 2023. The sample included short-stay inpatient admissions to US acute care and critical access hospitals. Adjusted analyses were conducted on a 20% random sample, with subgroup analyses of patients discharged to skilled nursing facilities. Data were analyzed from June 2024 to June 2025. Medicare coverage type at the time of hospital admission. Primary outcomes included length of stay (in days) and indicators for extended stays ( 7, 14, 21, and 28 days). Difference-in-differences regression models estimated changes in length of stay for Medicare Advantage relative to traditional Medicare, adjusting for patient demographics and hospital fixed effects. The sample included 89.3 million hospital admissions. Over the study period, the mean (SD) length of stay for Medicare Advantage admissions increased from 6.0 (5.7) to 7.1 (7.6) days compared with an increase from 5.8 (SD) to 6.3 (SD) days for traditional Medicare. By the end of the study period, Medicare Advantage admissions were 1.2 percentage points (95% CI, 1.0-1.3) more likely than traditional Medicare admissions to last 14 or more days, a 19.5% increase relative to the sample mean at baseline. Relative increases were larger for stays of 21 or more days (1.2 percentage points; 95% CI, 1.0-1.3; a relative increase of 25.1%) and 28 or more days (0.28, 95% CI, 0.23-0.33; a relative increase of 31.9%). Among patients discharged to skilled nursing facilities, the adjusted probability of Medicare Advantage admissions lasting 14 or more days increased by 3.1 percentage points (95% CI, 2.6-3.6) relative to traditional Medicare, a 28.1% increase relative to the baseline sample mean. In 2022 alone, prolonged stays among Medicare Advantage patients accounted for an estimated 1.8 million additional hospital bed-days, equivalent to 288 000 additional admissions with average length of stay. This cohort study found that from 2017 to 2023, Medicare Advantage beneficiaries experienced disproportionately greater increases in hospital length of stay than traditional Medicare beneficiaries, especially among those discharged to skilled nursing facilities. These trends may reflect insurance-related discharge barriers that contributed to millions of additional hospital bed-days.”

According to the news reporters, the research concluded: “As Medicare Advantage enrollment continues to grow, addressing barriers to discharge may be critical for improving hospital throughput and patient outcomes.”

This research has been peer-reviewed.

For more information on this research see: Extended Hospital Stays in Medicare Advantage and Traditional Medicare. JAMA Internal Medicine, 2025. JAMA Internal Medicine can be contacted at: Amer Medical Assoc, 330 N Wabash Ave, Ste 39300, Chicago, IL 60611-5885, USA.

Our news correspondents report that additional information may be obtained by contacting Andrew D. Wilcock, Dept. of Health Services Policy and Practice, Brown University School of Public Health, Providence, Rhode Island. Additional authors for this research include Brian E. McGarry, Ashvin D. Gandhi, David C. Grabowski and Michael L. Barnett.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1001/jamainternmed.2025.4411. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

The publisher of the journal JAMA Internal Medicine can be contacted at: Amer Medical Assoc, 330 N Wabash Ave, Ste 39300, Chicago, IL 60611-5885, USA.

(Our reports deliver fact-based news of research and discoveries from around the world.)