Lance's Corner

EHC Issues Seven New Resources

Aug 13, 2024

Per the notice below, the Effective Health Care (EHC) program has issued seven new resources, including seeking public input on them.

Opportunity to Comment on Draft Reports

We encourage the public to participate in the development of our research projects.  Comments can be submitted for:

Trauma Informed Care
(Available for comment until August 22, 2024)

The purpose of the review is to examine how Trauma Informed Care (TIC) and its components are defined and operationalized, and to examine the state of the evidence on effectiveness and potential harms of TIC approaches, frameworks, models, and components.

Opportunity to Submit Scientific Information

The Effective Health Care (EHC) Program is interested in receiving supplemental evidence and data (SEADs) for systematic reviews that are relevant to the questions in our evidence reports.  To ensure that it has full access to relevant research, whether or not it is published, the EHC Program is interested in receiving SEADs containing detailed study-specific information.  Opportunities to submit scientific information are available for:

Environmental, Clinical and Economic Outcomes of Hospital Resources to Prevent Hospital-Acquired Infections
(Available for submission until September 2, 2024)

Hospitals have long prioritized infection prevention while also aiming to limit operational expenses.  More recently, environmental responsibility has emerged as an important value in healthcare.  Balancing these often-competing interests of patient safety, cost minimization, and sustainability is a substantial challenge.  One key issue at the nexus of these concerns is the choice hospitals routinely face between medical devices and patient care items that are approved as reusable or are authorized for single-use reprocessing (i.e., a validated process for cleaning, disinfecting, and/or sterilizing a given device or item before reuse), and products that are discarded after one use.  While devices and items used only once are often promoted as a means to reduce the risk of hospital-acquired infections (HAI), they may increase hospital costs and lead to greater environmental impact.  Conversely, reprocessed devices and items may be environmentally friendlier but incur direct and indirect costs associated with reprocessing, and potentially increase patient exposure to infectious pathogens.  The Agency for Healthcare Research and Quality (AHRQ) is interested in the state of the science in respect to these issues and determined that a review of the evidence would inform programmatic planning.  However, the evidence is broadly dispersed across research on infection prevention, device utilization, and environmental impact, and studies rarely focus simultaneously on clinical, economic, and environmental outcomes, which makes it difficult to synthesize findings.  Additionally, the published literature consists primarily of non-randomized studies, life cycle assessments, modeling studies, and case reports, yielding results that cannot easily be compared.  Moreover, many single-use products and reprocessing procedures have been developed relatively recently, and research is still emerging.  Given these challenges, a traditional systematic review with meta-analyses and strength of evidence ratings might not be a feasible or appropriate approach to evaluating the evidence.  Therefore, we will develop a Technical Brief that aims to summarize the current landscape of evidence and identify key knowledge gaps, to inform and facilitate future research and programming.

(Section 944 (c) of the Public Health Service Act [42 U.S.C. 299c 3(c)] requires that information collected for research conducted or supported by AHRQ that identifies individuals or establishments be used only for the purpose for which it was supplied unless they consent to the use of the information for another purpose.)

Protocols Now Available

Patient safety research is growing, spanning across more healthcare settings, and considers a wide array of contextual factors.  The combination of emerging patient safety threats and the growing amount of published patient safety research, patient safety resources, and accrediting body standards makes it increasingly difficult to prioritize adoption and implementation of evidence-based practices.  AHRQ’s fourth iteration of Making Healthcare Safer intends to address this issue by publishing rapid evidence reports of patient safety practices and topics as they are completed.  The timely ongoing release of reports will aid healthcare organization leaders in prioritizing implementation of evidence-based practices in a timelier way.  These reports also will help researchers identify where more research is needed and assist policymakers in understanding which patient safety practices have the supporting evidence for promotion.  The following protocols are available:

Making Healthcare Safer IV: High Reliability Organization (HRO) as a Patient Safety Practice

Making Healthcare Safer (MHS) IV: Patient Monitoring Systems to Prevent Failure to Rescue

Making Healthcare Safer IV: Programs for Responding to Harms Experienced by Patients during Clinical Care

Making Healthcare Safer IV: Supply Chain Disruption Monitoring Programs

Making Healthcare Safer IV: Use of Structured Handoff Protocols for Intrahospital Transitions

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