The Citi Research group found that November 2013 hospital admissions were the lowest they have been in a decade (~4-5% lower than 2012). This drop is probably multifactorial, but likely exacerbated by the Medicare implementation of the “two midnight” rule. As all hospitalists are now well aware, Medicare requires patients to be placed in “observation” status if the intended duration of the hospital stay is 1-2 midnights. We will continue to see how this new Medicare rule affects inpatient volumes over time (link to article).
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