Medicare’s skilled nursing facility copayment policy could be causing residents to be discharged too soon from facilities, producing worse patient outcomes, according to University of Pennsylvania researchers. 

Medicare’s copayment policy for fee-for-service beneficiaries allows the program to fully cover a resident’s SNF stay for 20 days. The copayments increase for patients on day 21 of the benefit period. 

They found that 33.2% of all SNF admissions were discharged by day 20 of the benefit period. Beneficiaries also had a 36.7% readmission rate within 30 days of a SNF discharged, and a 43.1% readmission rate within 90 days. 

Staying one day longer in a SNF, however, was linked to lower readmissions within 30 and 90 days of hospital and SNF discharges. 

“Our findings suggest that efforts to reduce health care spending by curtailing post-acute care may have adverse consequences for patients,” researchers concluded. 

The study analyzed more than 290,000 SNF admissions for Medicare beneficiaries between 2012 and 2016. 

Findings were published Sunday in Health Services Research.