Lance's Corner

AHRQ Issues Regulatory Update

Aug 27, 2024

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

August 27, 2024, Issue #927

 

AHRQ Stats: Cost and Billing Trends for Sepsis-related Stays

Since 2016, aggregate hospital costs for sepsis stays increased by 66.8 percent, reaching $52.1 billion in 2021. More than 70 percent of the costs of sepsis inpatient stays were billed to public payers. (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #306 – Overview of Outcomes for Inpatient Stays Involving Sepsis, 2016–2021.)

 

Today's Headlines:

 

AHRQ-Funded Research Highlights Impact of Private Equity in Healthcare

Two AHRQ-funded publications provide insights into the growing trend of private equity ownership of healthcare facilities:

  • Between 2012 and 2023, 642 mental health clinics and 1,152 substance use treatment facilities in the U.S. were purchased by private equity entities, according to a research letter in JAMA Psychiatry. By 2023, private equity entities owned more than 6 percent of all mental health clinics and just over 7 percent of substance use treatment facilities.
  • A research letter in JAMA Internal Medicine indicated more than 60 percent of surveyed physicians had a negative view of private equity ownership and nearly 60 percent felt ownership negatively impacted physician well-being and cost. The survey of more 500 physicians showed around 45 percent of private-equity-employed physicians reported high job satisfaction and just under 50 percent felt they were given autonomy.

 

Advancing Impactful Research in Telehealthcare for 20 Years

teleheatlhAHRQ research that established the foundation for the nation’s expanding use of telehealthcare is the subject of a new AHRQ Views blog post. Telehealthcare is critical to delivering care in underserved areas and locations where specialized expertise is limited. An agency grant in 2004 led to the widespread adoption of Project ECHO, an early telementoring model. In 2020, the AHRQ ECHO National Nursing Home COVID-19 Action Network provided free training for infection prevention and safety practices during the height of the pandemic. Now celebrating its 20th anniversary, AHRQ’s Digital Healthcare Research Program continues to support research and provide guidance for the use of telehealthcare technologies. Access the blog post, authored by Kevin Chaney, M.G.S., senior advisor for dissemination and innovation in AHRQ’s Digital Healthcare Research Division, and Sanjeev Arora, M.D., F.A.C.G., founder and director of Project ECHO. To receive all blog posts, submit your email address.

 

Brief Addresses How AHRQ's Survey Tools Guide a Health System in Brazil in Improving Diagnostic Safety Culture

toolkitA new case study brief describes how a tertiary care health system in Sao Paulo, Brazil, Sociedade Beneficente Israelita Brasileira Albert Einstein, adapted AHRQ’s SOPS® Diagnostic Safety Supplemental Item Set to inform the development and implementation of a diagnostic excellence program. The survey-based assessment of physician perspectives helped target improvement actions and the implementation of multidisciplinary teamwork principles to enhance diagnostic accuracy and patient safety. Access the brief and other AHRQ publications related to diagnostic safety.

 

New Publication Highlights AHRQ Research in Medication Safety

Improving Patient Safety by Enhancing Medication Safety is the sixth in a series of AHRQ publications that summarize the agency’s investments in patient safety research as a pathway toward safer care. Medication safety refers to the practices and measures implemented to minimize the risk of medication errors and adverse drug events in various settings across the healthcare continuum. Since 2000, AHRQ has supported 123 patient safety projects related to medication safety. Access the research summary, which describes research projects and includes many final reports.

 

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).

 

Register Now for Sept. 23–24 Workshop on Advancing Equity in Diagnostic Excellence

Dx excellenceA Sept. 23–24 workshop will explore opportunities for improving equitable diagnosis with an emphasis on populations at greatest risk of harm from diagnostic errors. The AHRQ-supported Forum on Advancing Diagnostic Excellence will be hosted by the National Academies of Sciences, Engineering, and Medicine Forum on Advancing Diagnostic Excellence in collaboration with the Roundtable on the Promotion of Health Equity. Registrants may attend online or in person at the National Academy of Sciences Building, 2101 Constitution Ave NW, Washington DC. The workshop will include presentations on topics including factors that create barriers to high-quality diagnosis and strategies to reduce these barriers. Access more information, including how to register.

AHRQ in the Professional Literature

Beyond unplanned ICU transfers: linking a revised definition of deterioration to patient outcomes. Byrd TFT, Phelan TA, Ingraham NE, et al. Crit Care Med. 2024 Sep;52(9):e439-e49. Epub 2024 Jun 4. Access the abstract on PubMed®.

Specialist use among privately insured children with disabilities. Chien AT, Wisk LE, Beaulieu N, et al. Health Serv Res. 2024 Aug;59(4):e14199. Access the abstract on PubMed®.

Racial and ethnic disparities in opioid prescribing on hospital discharge among older adults: a national retrospective cohort study. Kasanagottu K, Anderson TS, Trivedi S, et al. J Gen Intern Med. 2024 Jun;39(8):1444-51. Epub 2024 Feb 29. Access the abstract on PubMed®.

Timing of treatment for opioid use disorder among birthing people. Kim K, Liu G, Dick AW, et al. J Subst Use Addict Treat. 2024 Jun;161:209289. Epub 2024 Jan 24. Access the abstract on PubMed®.

Using the age-friendly environment framework to assess advance care planning factors among older adults with limited income: a cross-sectional, descriptive survey study. Kimpel CC, Dietrich MS, Lauderdale J, et al. Gerontologist. 2024 Jul;64(7). Access the abstract on PubMed®.

Attitudes and barriers toward video visits in surgical care: Insights from a nationwide survey among surgeons. Kulkarni AJ, Thiagarajan AB, Skolarus TA, et al. Surgery. 2024 Jul;176(1):115-23. Epub 2024 May 12. Access the abstract on PubMed®.

Revealing complex interdependencies in surgical instrument reprocessing using SEIPS 101 tools. Segarra GC, Catchpole K, Rayo MF, et al. Appl Ergon. 2024 Sep;119:104307. Epub 2024 May 11. Access the abstract on PubMed®.

Harnessing health information technology to promote equitable care for patients with limited English proficiency and complex care needs. Strechen I, Wilson P, Eltalhi T, et al. Trials. 2024 Jul 4;25(1):450. 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