Lance's Corner

AHRQ Issues Regulatory Update

Sep 17, 2024

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

September 17, 2024, Issue #929

AHRQ Stats: Prevalence of Long COVID

Among adults who reported ever having COVID-19, 13.7 percent reported ever having Long COVID, and women were more likely than men to report ever having long COVID (16.5 percent vs. 10.5 percent). (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #557 – Prevalence of Long COVID Among Adults Who Have Ever Had COVID-19, by Selected Demographic and Socioeconomic Characteristics, U.S. Civilian Noninstitutionalized Population, Spring 2023)

Today's Headlines:

AHRQ Report to Congress Describes Sepsis’ Burgeoning Burden on Hospital Care

sepsisThe number of sepsis-related inpatient stays at non-federal acute care hospitals in the United States increased from 1.8 million in 2016 to 2.5 million in 2021, with a faster rate of increase following the emergence of COVID-19 in 2020, according to an AHRQ report to Congress. From 2016 to 2021, the aggregate hospital cost for inpatient stays due to sepsis at non-Federal acute-care hospitals in the United States increased from $31.2 billion to $52.1 billion, according to the report. Sepsis is a dysregulated systemic inflammatory response to infection that results in tissue damage and organ failure and can lead to death. AHRQ’s comprehensive federal analysis, based on data from the agency’s Healthcare Cost and Utilization Project (HCUP), includes detailed information on national trends in hospital utilization, morbidity, and in-hospital mortality; trends for key patient populations; disparities in hospital utilization for sepsis and associated outcomes; and state variations in hospital utilization and associated costs, and in-hospital mortality rates. Access the news release and additional AHRQ resources on sepsis.

 

On World Patient Safety Day, AHRQ Highlights Efforts to Address Diagnostic Safety

Dx safetyAHRQ’s support for World Patient Safety Day 2024, including this year’s theme of “Improving Diagnosis for Patient Safety,” is highlighted in a new AHRQ Views blog post. Up to 795,000 Americans die or are permanently disabled each year due to misdiagnosis, according to some estimates. AHRQ’s development of toolkits, issue briefs, and a training curriculum, as well as the establishment of 10 Diagnostic Safety Centers of Excellence, underscore the agency’s commitment to safe and timely diagnosis. The blog also highlights the ongoing work of the National Action Alliance for Patient and Workforce Safety, an initiative led by AHRQ on behalf of the Department of Health and Human Services. Access the blog post by AHRQ Director Robert Otto Valdez, Ph.D., M.H.S.A., and Craig A. Umscheid, M.D., M.S., director of AHRQ’s Center for Quality Improvement and Patient Safety. To receive all blog posts, submit your email address.

 

AHRQ Analysis Shows Progress in Reducing Patient Safety Events

A new analysis of hospitalized Medicare patients reveals a decline in adverse events since the peak of the COVID-19 pandemic, with a 13-to-15 percent reduction in adverse events in 2022 compared to 2021. The report, Adverse Events Among In-Hospital Medicare Patients in 2021 and 2022, was led by AHRQ in collaboration with the Centers for Medicare & Medicaid Services. It is based on data from AHRQ’s Quality and Safety Review System (QSRS), a new one-of-a-kind national repository that includes data on 41 types of adverse events and creates a baseline to assess the national impact of ongoing patient safety improvement initiatives. Among report highlights: in 2022, 6.2 percent of Medicare patients experienced at least one adverse event per hospital stay, a reduction from 7.1 percent in 2021.

 

Technical Assistance Webinar Scheduled Sept. 27 for AHRQ Healthcare Extension Service Cooperative Applicants

tech assistanceRegistration is open for a pre-application technical assistance webinar for organizations seeking to become one of AHRQ’s Healthcare Extension Cooperatives, a central part of AHRQ's emerging Healthcare Extension Service: State-Based Solutions to Healthcare Improvement. A recent Notice of Funding Opportunity announced AHRQ’s plan to award up to 15 grants to establish and support Healthcare Extension Cooperatives over 5 years. The Healthcare Extension Service will accelerate the dissemination and implementation of patient-centered outcomes research evidence into healthcare delivery. The webinar on Sept. 27 from 1 to 2 p.m. ET is optional for applicants. Attendees must complete a registration form, and logon information will be sent to participants about three days before the webinar. Presentation slides will be posted on the AHRQ website after the webinar. Questions may be submitted to AHRQ_HES@ahrq.hhs.gov.

 

Register Now for TeamSTEPPS for Diagnosis Improvement Training

trainingRegistration is open through November for virtual and limited in-person training in AHRQ’s TeamSTEPPS® for Diagnosis Improvement Course. TeamSTEPPS training has supported thousands of healthcare teams in their efforts to improve patient safety by enhancing communication and teamwork in hospitals, primary care practices, and other healthcare settings. Learn more about the TeamSTEPPS Diagnosis Improvement Course, which shows how healthcare teams can achieve safer, more accurate, and more timely diagnosis in all healthcare settings. The curriculum emphasizes patient engagement and includes discussions, videos, case-based scenarios, and other content. The training is free; continuing education credits will be available for a fee.

 

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).

 

New Research and Evidence From AHRQ

AHRQ in the Professional Literature

Trends in HPV-associated cancer incidence in Texas medically underserved regions. Hoang TN, Berenson AB, Shan Y, et al. Cancer Med. 2024 Aug;13(16):e70133. Access the abstract on PubMed®.

Cognitive, physical, and sensory deficits that can affect everyday medication use among older adults: a national view. Tang B, Espejo E, Steinman MA, et al. J Am Geriatr Soc. 2024 Jul;72(7):2254-7. Epub 2024 Apr 10. Access the abstract on PubMed®.

How the CAHPS Clinician and Group Patient Experience Survey data have been used in research: a systematic review. Quigley DD, Elliott MN, Qureshi N, et al. J Patient Cent Res Rev. 2024 Sum;11(2):88-96. Epub 2024 Jul 16. Access the abstract on PubMed®.

Practice facilitation to address unhealthy alcohol use in primary care: a cluster randomized clinical trial. Huffstetler AN, Villalobos G, Webel B, et al. JAMA Health Forum. 2024 Aug 2;5(8):e242371. Access the abstract on PubMed®.

Mortality for time-sensitive conditions at urban vs rural hospitals during the COVID-19 pandemic. Jiang HJ, Henke RM, Fingar KR, et al. JAMA Netw Open. 2024 Mar 4;7(3):e241838. Access the abstract on PubMed®.

AI-generated draft replies integrated into health records and physicians' electronic communication. Tai-Seale M, Baxter SL, Vaida F, et al. JAMA Netw Open. 2024 Apr;7(4):e246565. Access the abstract on PubMed®.

The effect of Medicare annual wellness visits on breast cancer screening and diagnosis. Hamer MK, Bradley CJ, Lindrooth R, et al. Med Care. 2024 Aug;62(8):530-7. Epub 2024 Jun 11. Access the abstract on PubMed®.

Transfer patterns among infants born at 28 to 34 weeks' gestation. Handley SC, Salazar EG, Kunz SN, et al. Pediatrics. 2024 Jan 1;153(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