The study estimated these barriers generated 1.8 million excess hospital bed-days in 2022 alone – equivalent to $5.5 billion in costs to hospitals. As MA enrollment continues to grow, SNFs face increasing census unpredictability from authorization delays.
Extended Hospital Stays in Medicare Advantage and Traditional Medicare
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. 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.
— JAMA Internal Medicine, September 8, 2025
McGarry, Brian E., et al. “Extended Hospital Stays in Medicare Advantage and Traditional Medicare.” JAMA Internal Medicine, 8 Sep. 2025. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2838539.
Slower Hospital Discharge of Medicare Advantage Patients Shapes SNF Admissions Practices
“Hospitals are holding patients longer while waiting for Medicare Advantage authorizations or in-network placement,” she said. “This is especially common with higher-acuity residents who clearly need skilled care — wound management, IV antibiotics, or respiratory support. By the time those patients reach us, they’ve often lost strength and function, and the window for recovery is smaller.”
— Skilled Nursing News, November 10, 2025
Longer Pre-SNF Hospital Stays More Likely for Medicare Advantage Beneficiaries
Hospital length of stay has been increasing more dramatically for Medicare Advantage beneficiaries than traditional Medicare beneficiaries, and this trend is especially pronounced for people who are discharged to a skilled nursing facility. Medicare Advantage-related slowdowns in hospital discharges are driving up costs to hospitals, perhaps by as much as $5.5 billion in 2023. But the situation also has negative effects on patients, who do not receive timely post-acute rehab and are at risk for longer periods of time to infections in the hospital.
— Skilled Nursing News, September 14, 2025
Over the study period, the mean length of stay for MA admissions increased from 6.0 to 7.1 days compared with an increase from 5.8 to 6.3 days for traditional Medicare. Additionally, MA admissions were 1.2% more likely than traditional Medicare admissions to last 14 or more days. Among those who were discharged to skilled nursing facilities, the adjusted probability of MA admissions lasting 14 or more days increased by 3.1%.
— McKnight’s Long-Term Care News, September 8, 2025
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