Lance's Corner

AHRQ Issues Regulatory Update

May 21, 2024

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

 
 

May 21, 2024, Issue #914

Editor’s note: Due to the Memorial Day holiday, AHRQ News Now will not publish next week.

AHRQ Stats

dental
Access more data on this topic in the associated statistical brief, plus additional AHRQ data infographics.

 

Today's Headlines:

 

AHRQ Views: Continuing a 35-Year History, AHRQ Pursues Vital Pathways To Improve Patient Care

valdezAHRQ’s essential role in advancing healthcare is the subject of a new blog post by agency Director Robert Otto Valdez, Ph.D., M.H.S.A. The blog—the second in a series celebrating AHRQ’s 35th anniversary—emphasizes the need to redouble efforts to improve healthcare not only in 2024 but also in the decades ahead. While the National Institutes of Health lead the way globally in biomedical research, AHRQ plays a leading role in technology assessment, which examines how new technologies can be introduced to improve current care delivery, and health services research, which supports progress by examining the organization, delivery and financing of today’s healthcare. AHRQ will continue to lead efforts to advance medical progress along these pathways, making today’s research tomorrow’s healthcare. To receive all blog posts, submit your email address.

 

Link Identified Between Hospice Provider Volume and Quality of Care in Assisted Living Facilities

hospiceHospice providers serving more assisted-living patients tended to receive lower-quality ratings than those caring for fewer patients, according to an AHRQ-funded study in the Journal of the American Geriatrics Society. Researchers based their findings on AHRQ’s Consumer Assessment of Healthcare Provider and Systems (CAHPS) Hospice Survey, which assesses the experiences of hospice patients who subsequently die and their caregivers. They found that among high-volume assisted-living hospice providers, quality was lower across several domains including pain assessment, dyspnea treatment, emotional support, team communications and family care training. Access the abstract.

 

Making Healthcare Safer IV Report Expanded With New Evidence Reviews

safer healthcareAs part of AHRQ’s ongoing efforts to advance patient safety, the agency has published two 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 settings.

 

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, including recent cases and commentaries and AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

 

Current Estimates Prevent Full Understanding of Consumers’ Spending on Primary Care

spendingMeasuring consumer spending on primary care is essential to improving healthcare delivery and outcomes, but an accurate picture of current spending is unknown because of variations in the ways that states conduct estimates, according to an AHRQ-funded research letter in JAMA Health Forum. For example, while nine states calculate primary care spending as a percentage of total healthcare spending, 10 others estimate spending by payor type. Lack of standardization and transparent measurements across states weakens what could be a powerful tool to monitor primary care investments, the authors concluded. They asserted that a standard primary care spending definition could lead to deeper understanding and help connect spending policy changes to health outcomes. Access the letter, which was based on an AHRQ technical brief.

 

Issue Brief Addresses Cognitive Load and its Impact on Diagnostic Accuracy

DxA new AHRQ issue brief provides an overview of fundamental cognitive load theory concepts. It dives into what is and is not yet known about the interplay between cognitive load theory and diagnostic accuracy, while providing a review of ways to measure and understand its causal impact on diagnostic accuracy. The brief concludes with recommendations for future research and improvement efforts. Access the brief and other AHRQ publications on diagnostic safety topics.

 

Study Finds Link Between Workplace and Patient Safety Cultures

The safety culture of hospital providers and staff is fundamentally linked to patient safety culture, according to an AHRQ study published in BMC Health Services Research. Researchers reviewed nearly 6,700 responses to AHRQ’s Surveys on Patient Safety Culture® (SOPS®) Hospital Survey 2.0 and the SOPS Hospital Workplace Safety Supplemental Item Set.  The largest number of associations between survey measures were overall support from hospital leaders; being able to report workplace safety problems without negative consequences; and overall rating on workplace safety. The study underscores the essential role of fostering robust safety cultures in healthcare to enhance safety and well-being for both staff and patients, researchers concluded.

 

Upcoming AHRQ Webinars

AHRQ in the Professional Literature

Development and evaluation of patient safety interventions: perspectives of operational safety leaders and patient safety organizations. Gomes KM, Handley J, Pruitt ZM, et al. J Patient Saf. 2024 May 13. [Epub ahead of print.] Access the abstract on PubMed®.

Leveraging human-centered design and causal pathway diagramming toward enhanced specification and development of innovative implementation strategies: a case example of an outreach tool to address racial inequities in breast cancer screening. Marcotte LM, Langevin R, Hempstead BR, et al. Implement Sci Commun. 2024 Mar 28;5(1):31. Access the abstract on PubMed®.

Cultural brokering in pregnancy care: a critical review. DiMeo A, Karlage A, Schoenherr K, et al. Int J Gynaecol Obstet. 2023 Nov;163(2):357-66. Epub 2023 Sep 8. Access the abstract on PubMed®.

Characterizing changes to older adults' care transition patterns from hospital to home care in the initial year of COVID-19. Arbaje AI, Hsu YJ, Zhou Z, et al. J Am Geriatr Soc. 2024 Apr;72(4):1079-87. Epub 2024 Mar 5. Access the abstract on PubMed®.

Utilization of electronic health record sex and gender demographic fields: a metadata and mixed methods analysis. Foer D, Rubins DM, Nguyen V, et al. J Am Med Inform Assoc. 2024 Apr 3;31(4):910-8. Access the abstract on PubMed®.

Race-ethnicity and sex differences in 1-year survival following percutaneous coronary intervention among Medicare fee-for-service beneficiaries. Savitz ST, Falk K, Stearns SC, et al. J Eval Clin Pract. 2024 Apr;30(3):406-17. Epub 2023 Dec 13. Access the abstract on PubMed®.

Association between Medicare's sepsis reporting policy (SEP-1) and the documentation of a sepsis diagnosis in the clinical record. Barbash IJ, Davis BS, Saul M, et al. Med Care. 2024 Jun;62(6):388-95. Epub 2024 Apr 12. Access the abstract on PubMed®.

Evaluating airway management in patients with trisomy 21 in the PICU and cardiac ICU: a retrospective cohort study. Wilsterman EJ, Jr., Nellis ME, Panisello J, et al. Pediatr Crit Care Med. 2024 Apr;25(4):335-43. Epub 2023 Dec 7. 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