Lance's Corner

AHRQ Issues Regulatory Update

Apr 23, 2024

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

April 23, 2024, Issue #910

AHRQ Stats: Dental Treat-and-Release Emergency Department Visits During the COVID-19 Era

teethThe number of treat-and release emergency department visits for dental conditions decreased 17.7 percent between 2019 and 2020. The largest decline was for nontraumatic dental conditions, which decreased 23.1 percent. (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #305, Treat-and-Release Emergency Department Utilization and Costs for Traumatic and Nontraumatic Dental Conditions, 2019 and 2020.)

Today's Headlines:

Making Healthcare Safer IV Report Expanded With New Evidence Reviews

As part of AHRQ’s ongoing efforts to advance patient safety, the agency has published four new evidence reviews to help healthcare leaders prioritize and implement safety strategies:

The reviews are part of the agency’s Making Healthcare Safer IV report, a continuous updating of evidence on 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. The reports align with the agency’s lead role in advancing safety, including establishment of the National Action Alliance for Patient and Workforce Safety, a growing public-private collaboration to improve safety across healthcare delivery setting.

Grantee Profile Highlights Work of Tina Hernandez-Boussard To Improve Healthcare Quality, Equity Through Data Analysis

granteeTina Hernandez-Boussard, Ph.D., M.P.H., associate dean of research at Stanford University School of Medicine, has dedicated her career to analyzing “clinical big data” to identify quality and safety issues that can result in adverse events. With funding from AHRQ, she has reviewed large datasets, such as ones with administrative claims data and electronic health records, to develop evidence-based standards, guidelines and decision-making tools for general healthcare practice, including surgical specialties and pain management. In conducting her research, Dr. Hernandez-Boussard, who is also a professor of medicine, biomedical data science and surgery at Stanford, is working to address and unravel bias in healthcare data. Check out Dr. Hernandez-Boussard’s profile and the profiles of other AHRQ grantees.

Upcoming AHRQ Webinars

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).

Now Available: 2021 Data on Hospital Care

AHRQ’s Healthcare Cost and Utilization Project (HCUP) has updated four databases to support researchers exploring issues related to hospital costs, utilization, access and quality. The 2021 HCUP Nationwide Databases are available for purchase through the HCUP Central Distributor Online Reporting System:

  • 2021 Nationwide Ambulatory Surgery Sample (NASS)
  • 2021 Nationwide Emergency Department Sample (NEDS)
  • 2021 Nationwide Readmissions Database (NRD)
  • 2021 Nationwide Inpatient Sample (NIS)

Also available are HCUP Software Tools:

HCUP, a federal-state-industry partnership, provides the largest collection of longitudinal hospital care data in the United States.

New Research and Evidence From AHRQ

AHRQ in the Professional Literature

A multi-center validation of the electronic health record admission source and discharge location fields against the clinical notes for identifying inpatients with long-term care facility exposure. Goodman KE, Taneja M, Magder LS, et al. Infect Control Hosp Epidemiol. 2024 Apr 18. [Epub ahead of print.] Access the abstract on PubMed®.

The consequences of firm scope and scale on patient access to healthcare. Meille G, Koch T, Wendling B, et al. Health Serv Res. 2024 Apr;59(2):e14228. Epub 2023 Sep 26. Access the abstract on PubMed®.

Delirium due to potentially avoidable hospitalizations among older adults. Whittington C, Skains RM, Zhang Y, et al. J Gerontol A Biol Sci Med Sci. 2024 Mar;79(3). Access the abstract on PubMed®.

Identifying and classifying diagnostic errors in acute care across hospitals: early lessons from the Utility of Predictive Systems in Diagnostic Errors (UPSIDE) study. Dalal AK, Schnipper JL, Raffel K, et al. J Hosp Med. 2024 Feb;19(2):140-5. Epub 2023 May 21. Access the abstract on PubMed®.

Care partner engagement in secure messaging between patients with diabetes and their clinicians: cohort study. Semere W, Karter AJ, Lyles CR, et al. JMIR Diabetes. 2024 Feb 9;9:e49491. Access the abstract on PubMed®.

Treatments for ADHD in children and adolescents: a systematic review. Peterson BS, Trampush J, Maglione M, et al. Pediatrics. 2024 Apr;153(4):e2024065787. Access the abstract on PubMed®.

Development of a comprehensive survey to assess key socioecological determinants of health. Smith B, Smith BP, Hollis RH, et al. Surgery. 2024 Apr;175(4):991-9. Epub 2023 Dec 28. Access the abstract on PubMed®.

Evaluating an electronic consultation platform to support pediatric primary care providers in caring for transgender and nonbinary adolescents. Sequeira GM, Asante PG, Bocek K, et al. Telemed J E Health. 2024 Feb;30(2):595-600. Epub 2023 Aug 25. 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