Lance's Corner

AHRQ Issues Regulatory Update

Oct 8, 2024

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

October 8, 2024, Issue #932

AHRQ Stats: In-Hospital Sepsis Mortality Rate Disparities

While the in-hospital mortality rate among all patients increased during the COVID-19 pandemic, Hispanic patients saw the greatest impact, with mortality rates rising by 64.3 percent between 2019 and 2021. (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #309, Racial and Ethnic Differences in Inpatient Stays Involving Sepsis, 2016-2021.)

Today's Headlines:

Highlighting the Urgent Need for Research on Improving Delivery of Preventive Services to People with Disabilities

preventionAHRQ’s efforts to increase access to clinical preventive services among people with disabilities is the subject of a new AHRQ Views blog post. Accessing appropriate screening, counseling, early treatment, vaccines and medications is vital to good health. Unfortunately, only 5.3 percent of those living with disabilities received all appropriate preventive services in 2020, according to Healthy People 2030. To eliminate these inequities, more research is urgently needed on interventions to increase the delivery of preventive services. To address the challenge, AHRQ recently delivered to Congress a report, Research to Improve the Delivery of Clinical Preventive Services to People with Disabilities. This agenda for new research, informed by an expert panel and a recently published AHRQ evidence review, recommends guiding principles for exploring the barriers, facilitators and interventions for delivering preventive services to people with disabilities. Access the blog post authored by AHRQ Director Robert Otto Valdez, Ph.D., M.H.S.A. To receive all blog posts, submit your email address.

Practice Facilitation Boosts Screening for Unhealthy Alcohol Use

alcoholPrimary care practices in Virginia that implemented AHRQ’s EvidenceNOW Model increased the use of recommended screening instruments for unhealthy alcohol use by 41.6 percent in the six months after they received practice facilitation that included tailored education, tools and assistance with workflows, according to an AHRQ-funded study published in JAMA Health Forum. During the same period, clinic-based counseling for unhealthy alcohol use improved by 35.6 percent. Given the number of people treated in the participating practices, this intervention resulted in an additional 171,500 patients being screened annually for unhealthy alcohol use. AHRQ’s EvidenceNOW: Managing Unhealthy Alcohol Use initiative is based on the EvidenceNOW Model, which is designed to help primary care practices increase their capacity for quality improvement with the goals of improving patient and practice health. Access the abstract.

New AHRQ Brief Provides Guidance on Community Engagement for Whole-Person Primary Care

engagementA new topic brief from AHRQ presents four case studies illustrating how primary care practices can effectively engage with their communities to support whole-person care. Whole-person care is a person-centered approach that considers the broader factors influencing health outcomes and emphasizes longitudinal relationships and comprehensive interdisciplinary, team-based care. Supporting whole-person care in primary care practices can increase access to care and quality of care and improve patient health outcomes and healthcare utilization. The brief was developed by AHRQ’s Academy, which provides topic briefs to support the integration of behavioral health and primary care.

Register Now for Technical Assistance Webinars for Applicants to AHRQ’s Healthcare Extension Service

Registration is open for two technical assistance webinars for applicants seeking to join AHRQ’s recently launched Healthcare Extension Service: State-based Solutions for Healthcare Improvement:

Webinar attendance is optional and is not a requirement to submit an application. Access more information about the initiative’s technical assistance resources.

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).

Now Available: 2024 Chartbook for the Consumer Assessment of Healthcare Providers and Systems Child Hospital Survey Database

kidsResults from AHRQ’s 2024 Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Child Hospital Survey Database are now available. The CAHPS Child Hospital Survey (Child HCAHPS) assesses inpatient care experiences of pediatric patients (17 and younger) and their parents or guardians. The survey covers many topics addressed by the adult version of the CAHPS Hospital Survey (HCAHPS) and additional topics relevant to pediatric care. Access the results via the chartbook and an infographic.

More AHRQ Webinars

New Research and Evidence From AHRQ

AHRQ in the Professional Literature

In-home health risk assessments and chart reviews contribute to coding intensity In Medicare Advantage. Jacobs PD. Health Aff. 2024 Jul;43(7):942-9. Access the abstract on PubMed®.

Patient-centered clinical decision support challenges and opportunities identified from workflow execution models. Sittig DF, Boxwala A, Wright A, et al. J Am Med Inform Assoc. 2024 Aug;31(8):1682-92. Access the abstract on PubMed®.

Pharmacist use of a population management dashboard for safe anticoagulant prescribing: evaluation of a nationwide implementation effort. Barnes GD, Chen C, Holleman R, et al. J Am Heart Assoc. 2024 Sep 17;13(18):e035859. Epub 2024 Sep 9. Access the abstract on PubMed®.

Assessing the Revised Safer Dx Instrument® in the understanding of ambulatory system design changes for type 1 diabetes and autism spectrum disorder in pediatrics. Brady PW, Ruddy RM, Ehrhardt J, et al. Diagnosis. 2024 Aug 1;11(3):266-72. Epub 2024 Mar 25. Access the abstract on PubMed®.

Development of a disease-based hospital-level diagnostic intensity index. Ellenbogen MI, Feldman LS, Prichett L, et al. Diagnosis. 2024 Aug 1;11(3):303-11. Epub 2024 Apr 22. Access the abstract on PubMed®.

eConsultation for deprescribing among older adults: clinician perspectives on implementation barriers and facilitators. Growdon ME, Hunt LJ, Miller MJ, et al. J Gen Intern Med. 2024 Oct;39(13):2461-70. Epub 2024 Jun 28. Access the abstract on PubMed®.

Lack of knowledge of antibiotic risks contributes to primary care patients' expectations of antibiotics for common symptoms. Laytner LA, Trautner BW, Nash S, et al. Ann Fam Med. 2024 Sep-Oct;22(5):421-5. Access the abstract on PubMed®.

Electronic health record-based screening for intimate partner violence: a cluster randomized clinical trial. Lenert L, Rheingold AA, Simpson KN, et al. JAMA Netw Open. 2024 Aug;7(8):e2425070. 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