Lance's Corner

AHRQ Issues Regulatory Update

Sep 24, 2024

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

 
 

September 24, 2024, Issue #930

AHRQ Stats: Prevalence of Long COVID According to Income

Among adults who ever had COVID-19, those living in high-income households were less likely to report ever having long COVID (11.0 percent) than those living in middle-income households (15.6 percent), low-income or near poor households (17.4 percent), and those living in poor households (17.2 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 Summit to Address Emergency Department Boarding

summitAn AHRQ summit on Oct. 8 from 9 a.m. to 1 p.m. ET will address the challenges of emergency department (ED) boarding. The live stream webcast will be aimed at identifying hospital- and health system-level solutions to circumstances that sometimes force patients to spend hours—or in some cases, days—in the ED while waiting for an inpatient bed or transfer to another facility. Interested audiences may include patients and consumers, clinicians, hospital and health system leaders, policy makers, experts in emergency medicine, community health, behavioral health, and specialty care providers. Brendan G. Carr, M.D., M.A., chief executive officer of Mount Sinai Health System, will be the featured speaker. The summit will also include a panel on the impacts of ED boarding and a session on “myths and matters” of ED boarding solutions. Access the live stream link on the day of the summit.

Shaping the Future of Patient Empowerment and Care Delivery Through Digital Healthcare Research

dymekAHRQ’s ongoing investments in research to improve patient care via digital healthcare technologies—including the burgeoning field of artificial intelligence—is the subject of a new AHRQ Views blog post authored by Chris Dymek, Ed.D., director of AHRQ’s Digital Healthcare Research Program. The blog post highlights the program’s newly released 2023 year-in-review report, Improving Healthcare Through AHRQ’s Digital Healthcare Research, which showcases AHRQ-funded projects focused on digital technologies that engage and empower patients and optimize and advance care delivery. Access the blog post, which describes how AHRQ-funded researchers have explored digital technologies’ potential to advance emergency department triage, screening for intimate partner violence, and other areas of healthcare. To receive all blog posts, submit your email address.

Topic Brief Provides Guidance on Behavioral-Developmental Health Screening for Young Children

screeningA new topic brief from AHRQ highlights five behavioral-developmental health screening and response models for children ages 0-5 and provides guidance for implementation in pediatric and family medicine practices. Behavioral-developmental health screening aims to provide families with young children the assistance and knowledge to promote foundational brain development during the first 5 years of life. The brief was developed by AHRQ’s Academy, which provides topic briefs to support the integration of behavioral health and primary care.

Register for AHRQ Webinars

New Software Enables Users to Produce Area-level Rates of Severe Maternal Morbidity

AHRQ has released new beta software that allows states and healthcare organizations to calculate severe maternal morbidity using readily available inpatient administrative claims data. By allowing access to detailed clinical data, the Maternal Health Indicators software helps organizations understand severe maternal morbidity trends and develop quality improvement efforts. It is not intended as an accountability measure or for comparisons across hospitals. As with all AHRQ quality measures, users may calculate the measures at an aggregate level or by race and ethnicity, payer, and other groups. AHRQ welcomes your feedback; comments or questions may be sent to QIsupport@ahrq.hhs.gov.

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).

National Academies Report Provides Goals to Improve Healthcare for Children, Youth, and Families

kidsA new report from the National Academies of Sciences, Engineering and Medicine explores how to better meet all children's needs and leverage community support by rethinking healthcare financing, public health investment, community partnerships, and accountability. Despite advances in healthcare, children—especially those from historically marginalized groups—face rising rates of chronic diseases, obesity, and mental health challenges. AHRQ was a co-sponsor of the report, which highlights goals and recommendations for equitable child and adolescent healthcare:
  • Elevate the importance of child and adolescent health through continuous public focus on children and youth.
  • Finance health systems for all children, emphasizing prevention and health promotion.
  • Strengthen community-level health promotion and disease prevention.
  • Ensure co-creation and co-design of programs and structures with youth, family and community voices, and leadership.
  • Implement measurement and accountability to ensure equitable goal achievement.
Access the report, Launching Lifelong Health by Improving Health Care for Children, Youth, and Families.

New Research and Evidence From AHRQ

AHRQ in the Professional Literature

Screening for unhealthy alcohol use among patients with multiple chronic conditions in primary care. Rockwell MS, Funk AJ, Huffstetler AN, et al. AJPM Focus. 2024 Aug;3(4):100233. Epub 2024 May 7. Access the abstract on PubMed®.

Use of telehealth among medical visits in the United States: results from the 2021 Medical Expenditure Panel Survey. Decker SL, Encinosa WE, Zuvekas SH. Ann Intern Med. 2024 Jul;177(7):987-90. Epub 2024 Jun 4. Access the abstract on PubMed®.

Cancer care coordination in rural Hawaii: a focus group study. Chang S, Liu M, Braun-Inglis C, et al. BMC Health Serv Res. 2024 Apr 24;24(1):518. Access the abstract on PubMed®.

The association between social vulnerability and geriatric assessment impairments among older adults with gastrointestinal cancers-The CARE Registry. Fowler ME, Harmon C, Tucker A, et al. Cancer. 2024 Sep 15;130(18):3188-97. Epub 2024 Jun 2. Access the abstract on PubMed®.

Evaluating the reach of a patient navigation program for follow-up colonoscopy in a large Federally Qualified Health Center. Gautom P, Rosales AG, Petrik AF, et al. Cancer Prev Res. 2024 Jul 2;17(7):325-33. Access the abstract on PubMed®.

Diagnostic errors in obstetric morbidity and mortality: methods for and challenges in seeking diagnostic excellence. Krenitsky NM, Perez-Urbano I, Goffman D. J Clin Med. 2024 Jul 20;13(14):4245. Access the abstract on PubMed®.

Surveillance of health care-associated violence using natural language processing. Waltzman M, Ozonoff A, Fournier KA, et al. Pediatrics. 2024 Aug 1;154(2). Access the abstract on PubMed®.

Assessing access to trauma-informed outpatient mental health services for adolescents: a mystery shopper study. Adams DR, Pérez-Flores NJ, Mabrouk F, et al. Psychiatr Serv. 2024 May;75(5):402-9. Epub 2023 Nov 29. 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