Lance's Corner

AHRQ Issues Regulatory Update

Jul 16, 2024

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

July 16, 2024, Issue #921

 

AHRQ Stats: Disorders Associated With Public Insurance Readmissions

In 2020, adult hospitalizations for sickle cell and anemia resulted in the highest readmission rates among patients using public insurance, leading to 37.7 30-day readmissions for every 100 hospitalizations among Medicare patients and 41.0 readmissions for every 100 hospitalizations among Medicaid patients. (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #307: Clinical Conditions With Frequent, Costly Hospital Readmissions by Payer, 2020.)

 

Today's Headlines:

 

AHRQ Views: Feeling Energized After Another Successful AcademyHealth Annual Research Meeting

valdezA new blog post by AHRQ Director Robert Otto Valdez, Ph.D., M.H.S.A., expresses his appreciation for the broad participation and robust presentations at AcademyHealth’s recent Annual Research Meeting (ARM). For the first time, AHRQ’s National Advisory Council held its summer meeting at the ARM, a chance for the organizations to affirm their shared goal of improving the delivery of healthcare by advancing health services research, a theme that was underscored in videotaped welcoming remarks by HHS Secretary Xavier Becerra during ARM's opening plenary session. AHRQ staff were instrumental in two special sessions: Innovations and Actions for Addressing Emergency Department Crowding, which addressed the consequences of this global phenomenon, and the Modernization of the Medical Expenditure Panel Survey (MEPS), which outlined AHRQ’s efforts to enhance one of the nation’s most valuable healthcare data resources. Access the blog post. To receive all blog posts, submit your email address.

 

AHRQ Data Show Nearly 10 Percent of Medical Visits in 2021 Conducted Using Telehealth

telehealthNearly 10 percent of all U.S. medical visits in 2021 occurred via telehealth, a new AHRQ data analysis shows. Researchers reviewed data from the AHRQ Medical Expenditure Panel Survey and found that in 2021, the first full calendar year under the COVID-19 global pandemic, 9.6 percent of all medical visits were via telehealth, with nearly 50 percent for mental healthcare. The analysis, published in Annals of Internal Medicine, showed that the use of telehealth varied widely, being more common among nonphysician clinicians, primary care providers and nonsurgical specialists. The researchers suggest that more research evaluating the costs and benefits of telehealth may help contribute to maximizing its potential to improve access for underserved populations. Access the article.

 

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

 

Register Now for AHRQ Webinars

AHRQ in the Professional Literature

Patient partnership tools to support medication safety in community-dwelling older adults: protocol for a nonrandomized stepped wedge clinical trial. Xiao Y, Fulda KG, Young RA, et al. JMIR Res Protoc. 2024 Apr 29;13:e57878. Access the abstract on PubMed®.

Development of a multimodal geomarker pipeline to assess the impact of social, economic, and environmental factors on pediatric health outcomes. Manning ER, Duan Q, Taylor S, et al. J Am Med Inform Assoc. 2024 Jun 20;31(7):1471-8. Access the abstract on PubMed®.

The emergency department trigger tool: multicenter trigger query validation. Griffey RT, Schneider RM, Kocher KE, et al. Acad Emerg Med. 2024 Jun;31(6):564-75. Epub 2024 Mar 18. Access the abstract on PubMed®.

Patient perceptions of and experiences with stigma using telehealth for opioid use disorder treatment: a qualitative analysis. Couch JV, Whitcomb M, Buchheit BM, et al. Harm Reduct J. 2024 Jun 27;21(1):125. Access the abstract on PubMed®.

A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022. Ashcraft LE, Goodrich DE, Hero J, et al. Implement Sci. 2024 Jun 24;19(1):43. Access the abstract on PubMed®.

A nationally representative summary of 2020 changes in the use of health care in the United States. Decker SL, Zuvekas SH. J Ambul Care Manage. 2024 Apr-Jun;47(2):64-83. Epub 2024 Feb 13. Access the abstract on PubMed®.

Completion rates and timeliness of diagnostic colonoscopies for rectal bleeding in primary care. Campbell KA, Sternberg SB, Benneyan J, et al. J Gen Intern Med. 2024 May;39(6):985-91. Epub 2023 Nov 8. Access the abstract on PubMed®.

Barriers and facilitators to guideline concordant dental antibiotic prescribing in the United States: a qualitative study of the National Dental PBRN. Ramanathan S, Yan C, Suda KJ, et al. J Public Health Dent. 2024 Jun;84(2):163-74. Epub 2024 Apr 1. 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