“We do believe it’s providing a moderate benefit,” Mr. Rutherford said on the health system’s April 26 earnings call.
In 2024, Medicare Advantage plans must provide coverage for an inpatient admission when the admitting physician expects the patient to require hospital care for at least two midnights, otherwise known as the two-midnight rule. The rule was included in the 2014 Medicare inpatient prospective payment system final rule. In 2023, CMS clarified in its final rule that MA plans must also follow the two-midnight rule, its case-by-case exception and the inpatient-only list beginning in 2024.
Mr. Rutherford said the health system is seeing some of its two-midnight inpatient volume grow, which it believes is due to the rule.
“But on the other side, it’s still early and not all claims have completed the adjudication process,” he said. “But at this point we still believe there’s going to be a modest benefit.”
Steve Filton, CFO of King of Prussia, Pa.-based Universal Health Services, however, said the rule has not affected inpatient acute volumes “best we can tell.”
“I think both our internal resources and our third-party consultants tell us that they’re not seeing a significant or measurable change in the behavior of our payers that’s really impacting our inpatient activity,” Mr. Filton said on the system’s April 25 earnings call, according to a transcript from Seeking Alpha. “I would say that in our minds, most of the growth in acute care volumes in the quarter is exclusive of any change in payer behavior.”
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.