Lance's Corner

AHRQ Issues Regulatory Update

Jun 4, 2024

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

June 4, 2024, Issue #915

AHRQ Stats: Maternal Deaths by Area Income

In 2020, among women living in the lowest-income areas, an average of 11 died for every 100,000 maternity admissions—more than twice the average of 5.1 deaths for every 100,000 maternity admissions among those living in the highest-income areas. (Source: AHRQ 2024 Chartbook on Patient Safety.)

Today's Headlines:

Racial and Ethnic Disparities Widened in Well-Child Visits During COVID-19

well-childThe COVID-19 pandemic led to an increase in racial and ethnic disparities among children in attendance to recommended well-child visits, according to an AHRQ study. The research, published in Academic Pediatrics, is discussed in a new podcast featuring the study’s lead author, AHRQ Senior Economist Salam Abdus, Ph.D. Data from AHRQ’s Medical Expenditure Panel Survey showed that average attendance to well-child visits decreased from 66.6 percent during the pre-pandemic period (2018–2019) to 58.6 percent in 2020. During those time periods, the unadjusted disparities in attendance widened from 9.6 percentage points to 24.8 percentage points between White non-Hispanic and Black non-Hispanic children, and from 14.8 percentage points to 26.3 percentage points between White non-Hispanic and Hispanic children. The authors concluded that the widening attendance disparities highlight the need to build a more equitable healthcare system for all children. Access the abstract.

AHRQ Views: Transforming Healthcare To Improve the Health and Well-Being of Older Americans

AHRQ’s growing efforts to improve healthcare for older adults, particularly those with multiple chronic conditions, is the subject of a new AHRQ Views blog post. Our current healthcare system is ill-equipped to meet the complex healthcare needs of older adults, who often receive suboptimal care that leads to avoidable adverse events, hospitalizations and other poor outcomes. A recent Special Emphasis Notice announced AHRQ’s interest in funding research proposals to address the development, implementation, evaluation and scalability of person-centered models of care to improve physical and mental health, functional status and overall well-being. The blog post asserts that future initiatives must prioritize equitable care for disadvantaged individuals and communities that have a higher burden of illness, less access to care and inadequate resources. Access the blog post. To receive all blog posts, submit your email address.

Grantee Profile Highlights Work of Jenn Leiferman To Address Maternal Depression

granteeJenn Leiferman, Ph.D., chair and professor in the Department of Community and Behavioral Health at the University of Colorado-Denver, focuses her research on maternal and child mental health. Mental health conditions, including perinatal or maternal depression that occurs during pregnancy and up to a year after delivery, are a leading underlying cause of pregnancy-related deaths in the United States. Dr. Leiferman has used AHRQ funding to develop and test educational interventions and strategies to address perinatal mental health. Access Dr. Leiferman’s grantee profile and the profiles of other AHRQ grantees.

Public School Systems Adapted AHRQ TeamSTEPPS® To Improve Mental Healthcare Services

kidsThree U.S. public school systems are pilot testing an adapted AHRQ TeamSTEPPS® team training curriculum to improve mental healthcare services for children. A new article published in the journal School Mental Health describes the work. The pilot project addresses challenges including limited resources (e.g., financial support, time and personnel) and communication issues through tailored training and implementation strategies. TeamSTEPPS is an evidence-based set of teamwork tools aimed at optimizing patient outcomes by improving communication and teamwork skills among healthcare teams, including patients and family caregivers. Access the article’s full text.

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).

New Research and Evidence From AHRQ

Explore Careers at AHRQ

Join the team that strives to improve healthcare for all Americans by investing in health systems research, creating strategies to support practice improvement and providing data and analytics to identify opportunities for improvement. Current vacancies include:

AHRQ in the Professional Literature

Using artificial intelligence to promote equitable care for inpatients with language barriers and complex medical needs: clinical stakeholder perspectives. Barwise AK, Curtis S, Diedrich DA, et al. J Am Med Inform Assoc. 2024 Feb 16;31(3):611-21. Access the abstract on PubMed®.

Conceptualizing and measuring trust, mistrust, and distrust: implications for advancing health equity and building trustworthiness. Richmond J, Anderson A, Cunningham-Erves J, et al. Annu Rev Public Health. 2023 Dec 15. [Epub ahead of print.] Access the abstract on PubMed®.

Impact of inpatient addiction psychiatry consultation on opioid use disorder outcomes. Kast KA, Le TDV, Stewart LS, et al. Am J Addict. 2024 Mar 28. [Epub ahead of print.] Access the abstract on PubMed®.

The association of oncology provider density with black-white disparities in cancer mortality in US counties. Zhang Y, Leifheit KM, Lee KT, et al. Cancer Control. 2024 Jan-Dec;31. Access the abstract on PubMed®.

Rural hospitals experienced more patient volume variability than urban hospitals during the COVID-19 pandemic, 2020-21. Jiang HJ, Henke RM, Fingar KR, et al. Health Affairs. 2024 May;43(5):641-50. Access the abstract on PubMed®.

Serious mental illness in assisted living communities: association with nursing home placement. Temkin-Greener H, Guo W, McGarry B, et al. J Am Med Dir Assoc. 2024 May;25(5):917-22. Epub 2024 Apr 1. Access the abstract on PubMed®.

Emergency department volume and delayed diagnosis of serious pediatric conditions. Michelson KA, Rees CA, Florin TA, et al. JAMA Pediatr. 2024 Apr;178(4):362-8. Access the abstract on PubMed®.

Case sampling for evaluating hospital postoperative morbidity in US surgical quality improvement programs. Chen VW, Rosen T, Dong Y, et al. JAMA Surg. 2024 Mar;159(3):315-22. 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