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Record W3184552258 · doi:10.1377/hlthaff.2021.00094

Medicare Two-Midnight Rule Accelerated Shift To Observation Stays

2021· article· en· W3184552258 on OpenAlexaff
Sabrina J. Poon, Christopher J.D. Wallis, Liliana Podczerwinski

Bibliographic record

VenueHealth Affairs · 2021
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicHealthcare Policy and Management
Canadian institutionsUniversity of Toronto
Fundersnot available
KeywordsMidnightMedicaidMedicinePaymentEmergency medicineMedical emergencyHospital careInpatient careBusinessHealth careEconomicsFinanceEconomic growth

Abstract

fetched live from OpenAlex

During the past two decades several policies have attempted to replace inappropriate hospital inpatient stays with observation hospital stays, where patients receive hospital care but are classified as outpatients. The Two-Midnight rule, adopted in October 2013 by the Centers for Medicare and Medicaid Services, states that more highly reimbursed inpatient payment is appropriate if care is expected to last at least two midnights; otherwise, observation stays should be used. For hospitals, the administrative burden associated with making these status determinations is substantial. We found that after the Two-Midnight rule was implemented, potentially inappropriate short inpatient stays decreased immediately by 2.0 stays per 1,000 beneficiaries and potentially more appropriate short outpatient stays increased immediately by 1.8 stays per 1,000 beneficiaries, hastening a preexisting trend in this direction. However, after this initial improvement, the rate of change slowed to a new steady state. Given the steady state and ongoing administrative resources needed, it is time to reconsider the value of status determination required by the Two-Midnight rule.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.019
metaresearch head score (Gemma)0.057
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.025
Threshold uncertainty score0.102

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0190.057
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.001
Science and technology studies0.0020.001
Scholarly communication0.0040.002
Open science0.0020.002
Research integrity0.0020.006
Insufficient payload (model declined to judge)0.0050.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.107
GPT teacher head0.323
Teacher spread0.216 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2021
Admission routes1
Has abstractyes

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