Lance's Corner

AHRQ Issues Regulatory Update

Aug 6, 2024

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

August 6, 2024, Issue #924

 

AHRQ Stats

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Access more data on this topic in AHRQ's 2023 Chartbook on Patient Safety, plus additional AHRQ data infographics.

 

Today's Headlines:

Intervention Leads to Increase in Lung Cancer Screenings

lungsLung cancer screening rates increased due to a multifaceted intervention, which included clinician reminders, shared decision-making tools and patient reminders, according to a new AHRQ-funded study published in JAMA Network Open. In a study of older patients in the Salt Lake City area with smoking history, the intervention improved lung cancer screening from 15.9 percent to 46.9 percent. The researchers noted that their findings highlight the effectiveness of structured interventions in improving early detection of and outcomes for lung cancer. Access the abstract.


Grantee Profile Highlights Work of Li Zhou To Improve Drug-Allergy Alerts

granteeLi Zhou, M.D., Ph.D., a professor of medicine at Harvard Medical School and a lead investigator at Boston’s Brigham and Women’s Hospital, has focused her research on developing technological innovations to enhance clinical decision support and patient safety. With AHRQ funding, Dr. Zhou has conducted groundbreaking patient safety research on medication reconciliation, allergy documentation, drug-allergy alerts and natural language processing­—a branch of artificial intelligence that makes it possible for people to talk to machines. Access more information about Dr. Zhou’s work, as well as profiles of other AHRQ grantees.


AHRQ Plan Identifies Strategies To Optimize Health and Function Among Older Adults

older adultsA new AHRQ strategic plan details strategies to achieve five goals for health system transformation to optimize the health, functional status and well-being of older adults. The U.S. population is rapidly aging, and the health system is ill prepared to meet the needs of older adults. However, much of the morbidity and premature mortality associated with aging can be delayed or slowed by re-engineering healthcare delivery systems in ways that improve health outcomes, functional status and well-being. In addition, chronic conditions can be effectively managed, allowing people to live independently and contribute to their communities longer. Access the plan, which includes more than two dozen strategies to advance the health and well-being of older adults.


Issue Brief Addresses Simulation To Improve Patient Safety

simulationMany organizations have invested in simulation capabilities but haven’t yet used these resources to improve patient safety. A new AHRQ issue brief, Simulation To Improve Patient Safety: Getting Started, describes why simulation can be a valuable asset, how to use simulation resources to improve patient safety and how to collaborate with simulationists. Access the issue brief, which includes examples of the positive impact of simulations implemented in a variety of patient care settings and practical strategies to advance patient safety through simulation and debriefing.


Register Now for Sept. 11 Webinar on Integrated Behavioral Health: The Journey to Becoming the Standard of Care

At an AHRQ webinar on Sept. 11 from 3 to 4 p.m. ET, members of the National Integration Academy Council (NIAC) will discuss the evolution of behavioral health integration and its increasing emergence as the standard of care. The panel will review the current state of behavioral health integration in primary care, provide an overview of its history and discuss the future of integration. The NIAC has served as the technical expert panel for AHRQ’s Academy for Integrating Behavioral Health and Primary Care since its founding in 2010. Access more information, including how to register for the webinar.

 

Consumer Surveys on Clinicians and Group Practices Valuable but Underused, Review Concludes

consumersHealthcare providers widely and successfully use data from AHRQ’s Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey to assess changes in their ratings and specific aspects of patient experience, but the data have untapped potential for studying consumer choice, a new AHRQ-funded literature review has found. Researchers found that healthcare providers are using the survey to assess a wide range of pre-post interventional changes in global ratings, such as overall provider ratings, and in specific aspects of patient experience, such as provider communication, access, courteous office staff and patient-centeredness. They concluded that healthcare providers value the survey as a means of assessing change, evaluating interventions and improving critical aspects of patient care experiences and healthcare delivery. 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).

 

Study Offers Insights on Patient-Centered Clinical Decision Support

Authors of a new AHRQ study called for new policies, processes, technologies and expertise to enhance patient-centered clinical decision support systems. In the study, published in the Journal of the American Medical Informatics Association, the authors used literature reviews, expert interviews and model refinement to highlight new considerations for patient-centered clinical decision support policies, processes, procedures, technology and expertise. They identified seven key challenges and opportunities, including but not limited to managing patient-generated health data and patient-reported outcomes, educating patients on device use and integrating patient data into electronic health records. The authors said their findings highlight the importance of adapting healthcare systems to ensure effective PC-CDS implementation, aiming for long-term improvements in health outcomes. Access the abstract.

AHRQ in the Professional Literature

Reducing antimicrobial overuse through targeted therapy for patients with community-acquired pneumonia: a study protocol for a cluster-randomized factorial controlled trial (CARE-CAP). Deshpande A, Walker R, Schulte R, et al. Trials. 2023 Sep 16;24(1):595. Access the abstract on PubMed®.

A virtual dissemination framework to inform and evaluate a neonatal Project ECHO (NeoECHO). Wyles CL, Shea K, Weiss A, et al. J Adv Nurs. 2024 Jul;80(7):2977-87. Epub 2023 Dec 10. Access the abstract on PubMed®.

Understanding the impacts of rural hospital closures: a scoping review. Mullens CL, Hernandez JA, Murthy J, et al. J Rural Health. 2024 Mar;40(2):227-37. Epub 2023 Oct 11. Access the abstract on PubMed®.

Health and economic value of eliminating socioeconomic disparities in US youth physical activity. Powell-Wiley TM, Martinez MF, Heneghan J, et al. JAMA Health Forum. 2024 Mar;5(3):e240088. Access the abstract on PubMed®.

Development and validation of the hospital-to-home-health transition quality (H3TQ) index: a novel measure to engage patients and home health providers in evaluating hospital-to-home care transition quality. Arbaje AI, Hsu YJ, Keita M, et al. Qual Manag Health Care. 2024 Jul-Sep;33(3):140-8. Epub 2024 Jun 26. Access the abstract on PubMed®.

Patient and provider satisfaction with asynchronous versus synchronous telepsychiatry in primary care: a secondary mixed-methods analysis of a randomized controlled trial. Yellowlees PM, Burke MM, Gonzalez AD, et al. Telemed J E Health. 2024 Apr;30(4):e1049-e63. Epub 2023 Nov 22. Access the abstract on PubMed®.

Integrating transformative considerations and quantitative results through a participant selection joint display in explanatory sequential mixed methods studies. James TG, Dejonckheere M, Guetterman TC. J Mix Methods Res. 2024 Jan;18(1):14-30. Epub 2022 Dec 27. Access the abstract on PubMed®.

Using simulation modeling to inform intervention and implementation selection in a rapid stakeholder-engaged hybrid effectiveness-implementation randomized trial. Becker JE, Shebl FM, Losina E, et al. Implement Sci Commun. 2024 Jun 24;5(1):70. 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