- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Medicare Coverage Gap?
Critics say a Medicare loophole leaves patients on the hook for tens of thousands of dollars.
It was an injustice Lee Barrows couldn't let stand. Her husband needed nursing home care after a week-long hospital stay. That’s something Medicare usually covers after three or more consecutive days as an admitted hospital patient. But Barrows soon found out she and her husband fell into a loophole.
"Around the fifth day he was there, this neurologist came flanked by a social worker and another doctor and said, ‘I'm sorry Mrs. Barrows, but your husband was never admitted,” said the Canton woman.
Unbeknownst to Lee, her husband had been placed on observation status by hospital officials instead of being considered an in-patient. So all that time in the hospital never counted towards his nursing home care, leaving Lee on the hook for tens of thousands of dollars out-of-pocket for any treatment after he left the hospital. Critics are calling it a coverage gap.
Read the full story here: http://bit.ly/19kESsa
Source: NBC News
Hospital Participation in Medicare ACOs: No Change in Admission Practices and Spending
August 19th 2025Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.
Read More
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
Listen
Care Quality Metrics in Medicare During COVID-19 Pandemic
August 12th 2025Medicare Advantage outperformed traditional Medicare on clinical quality measures before and during the COVID-19 pandemic; mid-pandemic, however, traditional Medicare narrowed the gap on some in-person screenings.
Read More
