Lance's Corner

AHRQ Issues Regulatory Update

Jun 11, 2024

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

June 11, 2024, Issue #916

 

AHRQ Stats: Distribution of Race/Ethnicity Among People With High Expenses

In 2021, Non-Hispanic White people were more likely to have higher healthcare expenditures than other race/ethnicity groups, comprising 74.1 percent of people in the top 5 percent healthcare expenditure tier. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #556, Concentration of Healthcare Expenditures and Selected Characteristics of Persons With High Expenses, United Stats Civilian Noninstitutionalized Population, 2018-2021.)

 

Today's Headlines:

 

AHRQ Announces Plans for National Healthcare Extension Service To Disseminate Evidence

Notice of Information issued by AHRQ signals the agency’s intent to publish a Notice of Funding Opportunity to create state-based healthcare extension cooperatives to increase the use of patient-centered outcomes research evidence in clinical practice. Cooperatives will work with Medicaid agencies, managed care organizations, community groups, policy and payment experts and others to improve care delivery. AHRQ will also issue funding opportunities for two related projects: a national coordinating center and a national evaluation center. Working together, these projects will be designed to accelerate the dissemination and implementation of patient-centered outcomes research evidence through improvements in healthcare policy, payment and practice, and to reduce healthcare disparities, especially among people who receive Medicaid, are uninsured or are otherwise medically underserved. Access more information about the initiative, plus a recent JAMA Networkviewpoint article by AHRQ experts.

 

AHRQ Views: Advancing Evidence-Based Medicine With Clinical Decision Support

AHRQ’s ongoing research investments in clinical decision support (CDS) and its potential to help clinical teams recommend the latest evidence-based medicine to patients is the subject of a new AHRQ Views blog post. AHRQ’s Digital Healthcare Research Program has supported CDS research, implementation and demonstration projects throughout its 20-year history. Among other initiatives, AHRQ’s CDS Connect provides a web-based platform for authoring, sharing and reusing CDS so healthcare systems and developers can build upon what has already been developed. A recent Notice of Intent signaled AHRQ’s intent to fund new research on patient-centered CDS to explore how to involve patients, families and caregivers in CDS development. Access the blog post. To receive all blog posts, submit your email address.

 

Register Now for June 18 Webinar on the National Action Alliance for Patient and Workforce Safety

Action AllianceRegistration is open for a webinar on June 18 from noon to 1 p.m. ET to highlight opportunities for elevating the patient voice when planning strategies for improving healthcare safety. The National Action Alliance for Patient and Workforce Safety, established by AHRQ on behalf of HHS, is a public-private collaboration that strives to improve safety across all healthcare settings. The webinar will feature presentations from experts at the Cincinnati College of Medicine who will discuss safety improvement efforts in pediatric care related to the following topics: listening to patient and family voices, strategies for meaningful engagement of patients and families, and the importance of workforce safety in driving patient safety. Access more information from previous National Action Alliance webinars and tools and resources to advance patient and workforce safety. Registration for future webinars is available on the National Action Alliance website.

 

Study Finds No Improvement From Antibiotics for Patients With Lower Respiratory Tract Infections

antibioticsPrescribed antibiotics did not reduce the duration and severity of coughing in patients with acute lower respiratory tract infections, a new AHRQ-funded study has found. The study, published in Journal of General Internal Medicine, analyzed data from more than 700 adult patients across primary and urgent care facilities in the United States. Researchers found that 29 percent of patients with cough and lower respiratory tract infection symptoms were prescribed antibiotics, but antibiotic provision did not affect cough duration or overall severity, regardless of viral, bacterial or mixed infections. Researchers concluded that patients had unrealistic expectations regarding the duration of lower respiratory tract infection and the effect of antibiotics, which should be the target of antibiotic stewardship efforts. Access the abstract.

 

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).

 

Registration Open for June 20 Webinar on Practice-Based Research Networks

primary careRegister now for the first webinar in a new AHRQ Practice-Based Research Networks (PBRN) learning series to support and promote the work of PBRNs. The webinar, Managing and Growing an Established PBRN, is scheduled for June 20 from 4 to 5 p.m. ET. PBRNs engage practicing primary care clinicians in asking and answering clinical and organizational questions about primary healthcare. The webinar series will feature examples, information and advice from leaders actively working in PBRNs. It is sponsored by AHRQ’s National Center for Excellence in Primary Care Research and is open to anyone interested in working with PBRNs.

AHRQ in the Professional Literature

 

Measuring access to mental health services among primary care patients. Hargraves JL, Cosenza C, Cleary PD. Med Care. 2024 Jun 6. [Epub ahead of print.] Access the abstract on PubMed®.

Telehealth safety framework: addressing a new frontier in patient safety. Gomes KM, Apathy N, Krevat S, et al. J Patient Saf. 2024 Jun 6. [Epub ahead of print.] Access the abstract on PubMed®.

Acute care utilization for ambulatory care-sensitive conditions among publicly insured children. Shapiro DJ, Hall M, Ramgopal S, et al. Acad Emerg Med. 2024 Apr;31(4):343-53. Epub 2024 Feb 22. Access the abstract on PubMed®.

Usability testing of situation awareness clinical decision support in the intensive care unit. Molloy MJ, Zackoff M, Gifford A, et al. Appl Clin Inform. 2024 Mar;15(2):327-34. Epub 2024 Feb 20. Access the abstract on PubMed®.

Does engagement matter? The impact of patient and community engagement on implementation of cardiovascular health materials in primary care settings. Zittleman L, Westfall JM, Callen D, et al. BMC Prim Care. 2024 Apr 25;25(1):135. Access the abstract on PubMed®.

Measuring equity in readmission as a distinct assessment of hospital performance. Nash KA, Weerahandi H, Yu H, et al. JAMA. 2024 Jan 9;331(2):111-23. Access the abstract on PubMed®.

Development and evaluation of I-PASS-to-PICU: a standard electronic template to improve referral communication for interfacility transfers to the pediatric ICU. Parikh NR, Francisco LS, Balikai SC, et al. Jt Comm J Qual Patient Saf. 2024 May;50(5):338-47. Epub 2024 Jan 24. Access the abstract on PubMed®.

Causal mediation of neighborhood-level pediatric hospitalization inequities. Brokamp C, Jones MN, Duan Q, et al. Pediatrics. 2024 Apr;153(4):e2023064432. 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