Medicare Advantage enrollees experience longer hospital stays before being discharged to post-acute care settings compared to individuals enrolled in traditional Medicare, according to a June 2025 analysis by NORC at the University of Chicago.
The analysis was commissioned by the Coalition to Strengthen America’s Healthcare, a group of more than 5,000 hospitals, businesses and hospital associations that includes the AHA and FAH.
Using Medicare Advantage encounter records and traditional Medicare claims from 2018 to 2022, researchers analyzed hospital discharges and the length of stay before discharge to post-acute care settings, including home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term acute care hospitals.
The researchers found that while hospital discharges overall declined over the five-year study period, discharges to post-acute settings increased for MA enrollees and decreased slightly for traditional Medicare enrollees. At the same time, MA enrollees had longer hospital stays prior to post-acute discharge, with the gap widening over time.
While the data is age-adjusted, the study did not control for clinical or demographic differences that could affect length of stay or discharge destination. Future research is recommended using tools like HCC risk scores and claims-based frailty index to better isolate coverage-related effects.
On July 2, AHIP called the NORC study “deeply flawed” and pointed to other research from earlier this year that found MA beneficiaries are less likely to be admitted to the hospital or re-admitted due to complications compared to traditional Medicare beneficiaries.
Four NORC study notes:
1. From 2018 to 2022, hospital discharges to post-acute care settings increased 5.6% for MA enrollees, while discharges for traditional Medicare beneficiaries declined 1.5%.
2. In 2022, median hospital length of stay before post-acute discharge was seven days for MA and five days for traditional Medicare. MA enrollees also had a higher length of stay across all years studied.
3. MA enrollees were more often discharged to home health agencies, while traditional Medicare beneficiaries were more likely to be discharged to higher-acuity settings. In 2022, MA plans discharged 12.4% more often to home health than traditional Medicare.
4. Across all four types of post-acute care, MA enrollees had significantly longer hospital stays before discharge in 2022 compared to those in traditional Medicare:
- Long-term acute care: 22 days for MA vs. 13 days for TM
- Inpatient rehab facilities: 10 days for MA vs. 6 days for TM
- Skilled nursing facilities: 9 days for MA vs. 6 days for TM
- Home health agencies: 6 days for MA vs. 4 days for TM
