Michael L. Barnett
@mlbarnett.bsky.social
2.1K followers 840 following 130 posts
health policy researcher, primary care physician, dad
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mlbarnett.bsky.social
New paper w/ Brian McGarry, Ashvin Gandhi, and Drew Wilcock in @jamainternalmed.com!

Hospitals are complaining across the US that patients are "stuck" waiting for rehab beds at nursing homes when they are medically stable and ready for discharge. What is going on??

jamanetwork.com/journals/jam...
Question Has hospital length of stay increased more for Medicare
Advantage beneficiaries than for traditional Medicare beneficiaries
since the COVID-19 pandemic?Findings In this cohort study involving more than 89 million
hospitalizations from 2017 to the third quarter of 2023, Medicare
Advantage beneficiaries experienced disproportionately greater
increases in extended hospital stays, especially among those
discharged to skilled nursing facilities.Meaning These findings suggest that the Medicare Advantage
plan design and practices may contribute to hospital discharge
delays, with implications for patient outcomes and hospital
capacity as enrollment continues to rise.
Reposted by Michael L. Barnett
archive.org
🐹 Before viral videos on TikTok or YouTube, there was Hampsterdance.

Full of dancing hamster GIFs & a sped-up tune, it became one of the internet’s first viral hits.

You can still dance to it on the #WaybackMachine ➡️ web.archive.org/web/19991222...

#Wayback1T

🧵
mlbarnett.bsky.social
sounds like a repeat experiment is coming soon? i need you here for moral support though
mlbarnett.bsky.social
well, beggars can't be choosers these days. X is not any better 😭
Reposted by Michael L. Barnett
aschwartz.bsky.social
Today's Nobel Prize in Medicine went to the discoverers of regulatory T-cells. How could this discovery about our immune systems change the world?

Here is one possible way: leading to treatments for terrible neurological diseases. (1/3)
Reposted by Michael L. Barnett
rkwadhera.bsky.social
Medicaid work requirements will soon be implemented nationwide

Our new @bmj.com study shows what happened to insurance coverage and jobs when Georgia rolled them out in 2023. bit.ly/3VE1QsK

Featured in @nytimes.com #medsky
www.nytimes.com/2025/09/30/w...
Medicaid Work Requirements Don’t Boost Employment, Study Shows
www.nytimes.com
Reposted by Michael L. Barnett
jama.com
JAMA @jama.com · 13d
Clinicians can enhance patient understanding by using numerical data instead of verbal probabilities, consistent denominators, absolute risk comparisons, and clear context for unfamiliar data types.

ja.ma/4pAC3zi
JAMA Insights: How to Communicate Medical Numbers. It outlines recommendations for conveying risk, adjusting numerators, communicating probability changes, using visualizations, and providing context, with examples of problematic and preferred communication styles.
Reposted by Michael L. Barnett
Reposted by Michael L. Barnett
johnrossmd.bsky.social
Important paper from @mlbarnett.bsky.social and colleagues

Patients with Medicare Advantage linger in hospital for a long time because of the limited rehab options it covers (tracks w/ what I see)

More evidence that Medicare Advantage is hot garbage that funnels public monies into private pockets
mlbarnett.bsky.social
Overall, we estimate that longer hospital stays for Medicare Advantage patients are contributing to close to 2 million extra hospital bed days occupied by people who don't need to be there any more annually. This is a huge waste and bad for patient care.

Why is this happening?
Reposted by Michael L. Barnett
thomasp85.com
I am beyond excited to announce that ggplot2 4.0.0 has just landed on CRAN.

It's not every day we have a new major #ggplot2 release but it is a fitting 18 year birthday present for the package.

Get an overview of the release in this blog post and be on the lookout for more in-depth posts #rstats
ggplot2 4.0.0
A new major version of ggplot2 has been released on CRAN. Find out what is new here.
www.tidyverse.org
Reposted by Michael L. Barnett
mlbarnett.bsky.social
New paper w/ Brian McGarry, Ashvin Gandhi, and Drew Wilcock in @jamainternalmed.com!

Hospitals are complaining across the US that patients are "stuck" waiting for rehab beds at nursing homes when they are medically stable and ready for discharge. What is going on??

jamanetwork.com/journals/jam...
Question Has hospital length of stay increased more for Medicare
Advantage beneficiaries than for traditional Medicare beneficiaries
since the COVID-19 pandemic?Findings In this cohort study involving more than 89 million
hospitalizations from 2017 to the third quarter of 2023, Medicare
Advantage beneficiaries experienced disproportionately greater
increases in extended hospital stays, especially among those
discharged to skilled nursing facilities.Meaning These findings suggest that the Medicare Advantage
plan design and practices may contribute to hospital discharge
delays, with implications for patient outcomes and hospital
capacity as enrollment continues to rise.
Reposted by Michael L. Barnett
lck303.bsky.social
I worked as a rehab nurse liaison for years, and anecdotally, can confirm what your research revealed. Another interesting avenue, look at comparing Medicare Advantage-covered IP days across the different insurance providers. I would presume a noticeable difference would present between the carriers
Reposted by Michael L. Barnett
rachelsachs.bsky.social
Thread. Super interesting new article with implications for a wide range of important topics in health policy, including hospital finances, patient outcomes, hospital capacity, insurance design, and more.
mlbarnett.bsky.social
New paper w/ Brian McGarry, Ashvin Gandhi, and Drew Wilcock in @jamainternalmed.com!

Hospitals are complaining across the US that patients are "stuck" waiting for rehab beds at nursing homes when they are medically stable and ready for discharge. What is going on??

jamanetwork.com/journals/jam...
Question Has hospital length of stay increased more for Medicare
Advantage beneficiaries than for traditional Medicare beneficiaries
since the COVID-19 pandemic?Findings In this cohort study involving more than 89 million
hospitalizations from 2017 to the third quarter of 2023, Medicare
Advantage beneficiaries experienced disproportionately greater
increases in extended hospital stays, especially among those
discharged to skilled nursing facilities.Meaning These findings suggest that the Medicare Advantage
plan design and practices may contribute to hospital discharge
delays, with implications for patient outcomes and hospital
capacity as enrollment continues to rise.
mlbarnett.bsky.social
Overall, we estimate that longer hospital stays for Medicare Advantage patients are contributing to close to 2 million extra hospital bed days occupied by people who don't need to be there any more annually. This is a huge waste and bad for patient care.

Why is this happening?
mlbarnett.bsky.social
When you break things down, the one group with higher lengths of stay are patients enrolled in Medicare Advantage plans - in particular, those going to a nursing home for rehab.

The likelihood that these patients stay in the hospital for ≥14 days increased by ~30% from 2018 to 2023.
mlbarnett.bsky.social
We studied Medicare hospital claims from 2017 to 2023 and found something striking.

The likelihood that any hospital stay in Medicare was longer than 14, 21 or 28 days (a VERY long time for a hospital stay)has gone up substantially since the pandemic and stayed high. There's a pattern, though ...