Lance's Corner

AHRQ Issues Regulatory Update

Jul 30, 2024

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

July 30, 2024, Issue #923

 

AHRQ Stats: Postoperative Sepsis Rates

In 2020, for every 1,000 elective surgical procedures, an average of 3.8 adult patients developed postoperative sepsis. Those aged 65 and older faced a greater risk—for every 1,000 elective surgical procedures, an average of 4.3 patients developed sepsis. (Source: AHRQ 2024 Chartbook on Patient Safety.)

 

Today's Headlines:

 

Study Shows Strong Link Between Smoking, Opioid Use

smokesA new analysis of data from AHRQ’s Medical Expenditure Panel Survey (MEPS) revealed a strong link between smoking and opioid use, emphasizing the need for integrated treatment programs. Data from 2013 to 2021 from MEPS and the Centers for Disease Control and Prevention’s National Health Interview Survey show that although only 37 percent of the population has ever smoked, smokers account for 69 percent of annual prescription opioid use. Heavy smokers, just 12 percent of the population, collectively use as many opioids as the 63 percent who never smoked. Smokers also report higher rates of chronic pain, severe work limitations due to pain and poor mental health. The authors, published in the American Journal of Preventive Medicine, suggested that combining smoking cessation with substance abuse treatment could be crucial in addressing the opioid epidemic. Access the abstract.

 

AHRQ Data Indicate 7 Percent of U.S. Adults Have Had Long COVID

Long COVIDNew data from AHRQ’s Medical Expenditure Panel Survey indicate that about 7 percent of U.S. adults, 17.8 million, have had Long COVID as of early 2023. Hispanic and White adults had higher rates of Long COVID than Asian and Black adults, and women had higher rates than men. Adults who received a COVID-19 booster had lower rates of Long COVID than both unvaccinated adults and adults who received only the primary vaccination series. Adults with obesity or preexisting chronic conditions were also more likely to have had Long COVID than all adults. Researchers said the findings support previously reported estimates. Access a summary of the article published in JAMA.

 

New Videos Show How To Explore AHRQ Data Tools

videosNew videos from AHRQ provide guidance on the use of AHRQ Data Tools, an interactive resource that allows researchers, policymakers and others to explore data on topics ranging from health insurance coverage to hospital use to disparities in care. An introductory video is complemented by three additional videos that offer more detailed instructions and examples of how to use AHRQ data resources:

 

Community-Level Factors Linked to Pediatric Outcome Inequities

Structural racism seems to be a significant root cause of inequities in child health outcomes, including those at the population level, according to a new AHRQ-funded study in Pediatrics. Researchers found that pediatric hospitalizations increased by more than 6 percent for every 10 percent of the population in a census tract that identified with a “historically marginalized” racial group. This review combined data from nearly 60,000 hospitalizations with community-level factors related to community material deprivation, crime risk, primary language, housing tenure, family composition, hospital access, greenspace, traffic-related air pollution and housing conditions. When they weighted their measurements to account for these systemic inequities, they found that inequities in pediatric hospitalizations disappeared. Researchers concluded that interventions and policies that address such exposures and dismantle racist structures could promote better, more equitable child health outcomes. Access the abstract.

 

Apply Now for Funding on Projects To Reduce Healthcare-Associated Infections and Antibiotic Resistance

hand washingAHRQ is funding innovative research proposals to prevent healthcare-associated infections (HAIs) and combat antibiotic-resistant bacteria (CARB). Applications are due September 25 for demonstration and dissemination projects (R18) and October 5 for large research projects (R01). HAI projects in both grant categories should demonstrate new ways to detect, prevent and reduce HAIs. CARB projects should address ways to promote appropriate antibiotic use, reduce the transmission of resistant bacteria or prevent HAIs. The funding is available to support research in all healthcare settings: long-term care, ambulatory care, acute care hospitals and those focusing on transitions between care settings. AHRQ encourages potential applicants to consider research in healthcare delivery areas with demonstrated health inequities and to address those equity issues in their proposed projects.

 

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).

 

AHRQ Seeks Nursing Homes for Pilot Test of Surveys on Patient Safety Culture Nursing Home Survey 2.0

nursing homeAHRQ seeks nursing homes to participate in a pilot test of an update to the Surveys on Patient Safety Culture® (SOPS®) Nursing Home Survey (Version 2.0) with supplemental items assessing staff workplace safety. The 2.0 revised survey is shorter than the current 1.0 survey and includes new items. Participating nursing homes will receive up to $1,000, free survey administration to nursing home staff, and feedback reports displaying results compared with other pilot sites. For more information, contact NursingHomeSurvey@westat.com.

 

New Research and Evidence From AHRQ

AHRQ in the Professional Literature

Characterizing proximity and transfers of deceased organ donors to donor care units in the United States. Vail EA, Tam VW, Sonnenberg EM, et al. Am J Transplant. 2024 Jun;24(6):983-92. Epub 2024 Feb 10. Access the abstract on PubMed®.

Ethnic disparities in deep sedation of patients with acute respiratory distress syndrome in the United States: secondary analysis of a multicenter randomized trial. Armstrong-Hough M, Lin P, Venkatesh S, et al. Ann Am Thorac Soc. 2024 Apr;21(4):620-6. Access the abstract on PubMed®.

Trends in psychological distress and outpatient mental health care of adults during the COVID-19 era. Olfson M, McClellan C, Zuvekas SH, et al. Ann Intern Med. 2024 Mar;177(3):353-62. Epub 2024 Feb 6. Access the abstract on PubMed®.

Development of patient safety measures to identify inappropriate diagnosis of common infections. White AT, Vaughn VM, Petty LA, et al. Clin Infect Dis. 2024 Jun 14;78(6):1403-11. Access the abstract on PubMed®.

Older adults with overlapping caregiving responsibilities and care needs in a U.S. national community-based sample. Semere W, Yank V, Lisha NE, et al. J Am Geriatr Soc. 2024 Jun;72(6):1824-30. Epub 2024 Feb 12. Access the abstract on PubMed®.

Natural language processing applied to clinical documentation in post-acute care settings: a scoping review. Scharp D, Hobensack M, Davoudi A, et al. J Am Med Dir Assoc. 2024 Jan;25(1):69-83. Epub 2023 Oct 11. Access the abstract on PubMed®.

Medicaid managed care and pediatric dental emergency department visits. Baker L, Munnich EL, Kranz AM. JAMA Health Forum. 2024 Jun 7;5(6):e241472. Access the abstract on PubMed®.

Applying ordered network analysis to video-recorded physician-nurse interactions to examine communication patterns associated with shared understanding in inpatient oncology care settings. Popov V, Tan Y, Manojlovich M. BMJ Open. 2024 Jun 17;14(6):e084653. 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