Lance's Corner

AHRQ Issues Regulatory Update

Feb 13, 2024
The Agency for Healthcare Research and Quality has issued its weekly regulatory update, which can be read below.

AHRQ News Now banner updated 2023

February 13, 2024, Issue #900


AHRQ Stats: Electronic Nicotine Product Use Among Adults

Overall, 15.5 percent of U.S. noninstitutionalized adults reported having used an electronic nicotine product in 2021. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #554, Characteristics of Young Adults Aged 18-24 Who Had Ever Used an Electronic Nicotine Product, 2021.)


Today's Headlines:


Patient Narratives Can Catalyze Staff Improvement and Bolster Survey Scores

narrativesPatient narratives—feedback from patients in their own words, collected through structured open-ended survey questions—can help improve patient experience and organizational learning, according to two new AHRQ-funded studies. The first study, published in Health Services Research, examined an online reporting tool designed to interpret patients’ narrative feedback in 22 ambulatory practice sites. Use of the tool, which included AHRQ’s CAHPS® Clinician & Group Survey with Narrative Item Sets, improved scores for office staff interactions and wait time, but provider listening scores slightly declined. In the second study, published in Health Care Management Review, researchers explored how sharing patients' stories could improve healthcare in nine primary care clinics over a year. They found that regularly sharing patients’ narratives with staff significantly improved patient experience survey scores, depending on staff confidence levels.

 


Making Healthcare Safer IV Report Expanded With New Evidence Reviews

New evidence reviews from AHRQ are available to help healthcare leaders prioritize and implement strategies to improve patient safety in five areas:

The reviews are part of the agency’s Making Healthcare Safer IV report, a continuous updating of patient safety harms and practices. First published in 2001, Making Healthcare Safer reports have consolidated information sources for healthcare providers, health system administrators, researchers, and government agencies. Among additional patient safety topics that will be added to Making Healthcare Safer IV in coming months: fatigue and sleepiness of clinicians due to hours of service; transmission-based precautions for multidrug-resistant organisms; and infection surveillance for Clostridiodes difficile, methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Enterobacterales (CRE), and Candida auris.


Register Now for March 7 Webinar on Integrating Behavioral Health in Primary Care

behavioralA webinar on March 7 from 2 to 3:15 p.m. ET will highlight AHRQ-funded research on the integration of behavioral health in primary care. Sponsored by AHRQ’s National Center for Excellence in Primary Care Research, the webinar will feature AHRQ grantees who are researching behavioral health tools and interventions in ambulatory care settings. It will also highlight tools and research from The Academy, AHRQ’s national resource for integrating behavioral health and primary care. Attendees will be encouraged to participate in a question-and-answer session. Register for the webinar.

 


Eastern Virginia Medical School Uses, Contributes to AHRQ's Healthcare Simulation Dictionary

EVMSA new AHRQ Impact Case Study tells how Eastern Virginia Medical School (EVMS) in Norfolk, Va., uses and contributes to the AHRQ Healthcare Simulation Dictionary. Simulation in healthcare creates a safe learning environment for healthcare practitioners and teams to test and improve new clinical processes and techniques before touching patients. EVMS has been incorporating simulation training into its medical education for about 30 years. (Above, EVMS Simulation Director Bob Armstrong reviews the AHRQ Healthcare Simulation Dictionary with team members.) Access the EVMS Impact Case Study and explore nearly 500 AHRQ Impact Case Studies by topic, location, or product.

 


Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).


Report Highlights 30 Years of AHRQ’s Primary Care Research

A new report from AHRQ’s National Center for Excellence in Primary Care Research describes three decades (1990–2020) of AHRQ’s primary care research and highlights how that research has impacted delivery of primary care. The report details AHRQ’s investments in research to improve primary care organization, workforce, quality and safety, digital healthcare, finance and cost, and prevention. These investments have positively impacted research, policy, clinical practice, and health outcomes. Find out more about this research and tools and resources to support primary care at AHRQ’s National Center for Excellence in Primary Care Research.


AHRQ in the Professional Literature


A retrospective cohort study of the 2018 angiotensin receptor blocker recalls and subsequent drug shortages in patients with hypertension. Devine JW, Tadrous M, Hernandez I, et al. J Am Heart Assoc. 2024 Jan 2;13(1):e032266. Epub 2023 Dec 29. Access the abstract on PubMed®.

Ambulatory care coordination data gathering and use. Geary CR, Hook M, Popejoy L, et al. Comput Inform Nurs. 2024 Jan;42(1):63-70. Access the abstract on PubMed®.

Hemoglobin on admission for childbirth and postpartum acute care use in a southeastern health care system. Bruce KE, Busse CE, Tully KP, et al. Am J Perinatol. 2024 Jan 11. [Epub ahead of print.] Access the abstract on PubMed®.

Organizational and community resilience for COVID-19 and beyond: leveraging a system for health and social services integration. Fleming MD, Safaeinili N, Knox M, et al. Health Serv Res. 2024 Feb;59(suppl 1):e14250. Epub 2023 Oct 16. Access the abstract on PubMed®.

Anesthesia workspaces for safe medication practices: design guidelines. Mohammadigorji S, Joseph A, Mihandoust S, et al. HERD: Health Environments Research & Design Journal. 2024 Jan;17(1):64-83. Epub 2023 Aug 8. Access the abstract on PubMed®.

Automating risk stratification for geriatric syndromes in the emergency department. Haimovich AD, Shah MN, Southerland LT, et al. J Am Geriatr Soc. 2024 Jan;72(1):258-67. Epub 2023 Oct 9. Access the abstract on PubMed®.

Health literacy-informed communication to reduce discharge medication errors in hospitalized children: a randomized clinical trial. Carroll AR, Johnson JA, Stassun JC, et al. JAMA Netw Open. 2024 Jan 2;7(1):e2350969. Access the abstract on PubMed®.

The TeamSTEPPS for improving diagnosis team assessment tool: scale development and psychometric evaluation. Ali KJ, Goeschel CA, Eckroade MM, et al. Jt Comm J Qual Patient Saf. 2024 Feb;50(2):95-103. Epub 2023 Aug 30. Access the abstract on PubMed®.


Contact Information

For comments or questions about AHRQ News Now, contact Bruce Seeman, (301) 427-1998 or Bruce.Seeman@ahrq.hhs.gov.


USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc