Lance's Corner

AHRQ Issues Regulatory Update

Aug 20, 2024

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

August 20, 2024, Issue #926

 

AHRQ Stats: Sepsis-related Inpatient Stays Increased between 2016-2021

sepsisFrom 2016 to 2019, the number of all sepsis-related inpatient stays in the U.S. increased by 20.1 percent to 2.1 million stays. With the emergence of COVID-19, inpatient stays related to sepsis reached about 2.5 million in 2021. (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #306 – Overview of Outcomes for Inpatient Stays Involving Sepsis, 2016 – 2021.)

 

Today's Headlines:

 

Healthcare Spending Higher Among Adults Who Had Adverse Childhood Experiences

A first-time estimate of healthcare spending among adults with adverse childhood experiences (ACEs) is the subject of a new AHRQ Views blog post. AHRQ’s research team—Thomas M. Selden, Ph.D.; Didem M. Bernard, Ph.D.; Sandra L. Decker, Ph.D.; and Zhengyi Fang, M.S.—found that in 2021, 62.6 percent of adults reported at least one ACE, such as household members' substance abuse or mental illness, divorced or separated parents, and physical, verbal, or sexual abuse. Adults with ACEs had 26.3 percent higher healthcare expenditures compared to those without ACEs, according to the research published in Health Affairs. In their blog post, AHRQ Director Robert Otto Valdez, Ph.D., M.H.S.A., and Dr. Selden emphasize how the research provides an urgent signal to improve the quality of healthcare and social services for those with ACEs by transforming our care delivery systems to be more person-centered. Access the blog post. To receive all blog posts, submit your email address.

 

Impact Case Study: New Mexico Hospital Uses AHRQ Toolkit To Slash Catheter Use, Eliminate Infections

case studySierra Vista Hospital in Truth or Consequences, New Mexico, implemented practices from AHRQ’s Toolkit for Reducing Catheter-Associated Urinary Tract Infections (CAUTIs) in Hospitals. The result: the 11-bed critical access hospital reduced the number of indwelling urinary catheter days by more than 90 percent and has not had a recurrence of CAUTI in more than a year. Catheter utilization per 1,000 patient days fell from 0.42 in 2021 to 0.19 in 2023 and sits at 0.20 through the first half of 2024. Learn more about the efforts of the Sierra Vista Hospital team (shown above) in the AHRQ Impact Case Study.

 

Consumer Surveys on Clinicians and Group Practices Valuable But Underused

surveysHealthcare 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, an AHRQ-funded literature review found. Researchers concluded that the survey is being used by healthcare providers successfully to assess a wide range of pre-post interventional changes in global ratings, such as overall provider rating or would recommend office or provider, 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.

 

Register Now: September 17 Virtual Research Meeting on the Use of Patient-reported Experience and Outcome Measures

Registration is open for AHRQ’s Consumer Assessment of Healthcare Systems and Providers virtual research meeting on Sept. 17 from 11 a.m. to 4 p.m. ET to explore the differences between patient-reported experience measures and patient-reported outcome measures, how they are connected, and how they can be used to measure and improve the quality and value of healthcare. Access more information, including how to register and a meeting agenda.

 

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&Ms (Morbidity and Mortality Rounds on the Web).

 

New Research and Evidence From AHRQ

New Research and Evidence From AHRQ

 

Upcoming AHRQ Webinars

AHRQ in the Professional Literature

Racial and ethnic disparities in attendance to well-child visit recommendations during COVID-19. Abdus S, Selden TM. Acad Pediatr. 2024 Aug;24(6):922-9. Epub 2024 Apr 16. Access the abstract on PubMed®.

Mental health care use and quality among Medicaid adults with serious mental illness receiving care at Federally Qualified Health Centers vs. other settings. Myong C, Yang Z, Behr C, et al. BMC Health Serv Res. 2024 Jul 17;24(1):825. Access the abstract on PubMed®.

Interventions to improve system-level coproduction in the Cystic Fibrosis Learning Network. Gamel B, Albon D, Bandla S, et al. BMJ Open Qual. 2024 Jul 27;13(3):e002860. Access the abstract on PubMed®.

National trends in billing patient portal messages as e-visit services in traditional Medicare. Liu T, Zhu Z, Holmgren AJ, et al. Health Affairs Scholar. 2024 Apr;2(4):qxae040. Epub 2024 Apr 3. Access the abstract on PubMed®.

Scaling the EQUIPPED medication safety program: traditional and hub-and-spoke implementation models. Vandenberg AE, Hwang U, Das S, et al. J Am Geriatr Soc. 2024 Jul;72(7):2184-94. Epub 2024 Jan 23. Access the abstract on PubMed®.

Development and implementation of a digital quality measure of emergency cancer diagnosis. Kapadia P, Zimolzak AJ, Upadhyay DK, et al. J Clin Oncol. 2024 Jul 20;42(21):2506-15. Epub 2024 May 8. Access the abstract on PubMed®.

Management of depression in adults: a review. Simon GE, Moise N, Mohr DC. JAMA. 2024 Jul 9;332(2):141-52. Access the abstract on PubMed®.

An institutional approach to equity and improvement in child health outcomes. Unaka N, Kahn RS, Spitznagel T, et al. Pediatrics. 2024 Aug 1;54(2). 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