Lance's Corner

AHRQ Issues Regulatory Update

Nov 5, 2024

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

November 5, 2024, Issue #936

AHRQ Stats: Long COVID Rates by Sex

As of spring 2023, 16.5 percent of women who had been diagnosed with COVID-19 reported having developed Long COVID, compared with 10.5 percent of men. (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 Views: New Quality Indicator Aimed at Addressing Maternal Morbidities

maternalAHRQ’s maternal health improvement efforts, including development of quality indicators for analyzing severe maternal morbidity trends, are the subject of an AHRQ Views blog post. An estimated 60,000 U.S. women are affected each year by serious pregnancy-related complications. The crisis is particularly acute for Black women, Native women and women in rural communities. The new Maternal Health Indicators (MHI) software module, currently in testing phase, allows state organizations, payers, researchers, healthcare providers and others to track maternal morbidity trends, develop improvement strategies and conduct research using administrative (billing or claims) data—an important option for groups without access to clinical data. The tool exemplifies AHRQ’s maternal health improvement efforts, which include data analyses and a toolkit to advance perinatal safety. Access the blog post, authored by AHRQ Health Statistician Whitney Schott, Ph.D., and Judy George, Ph.D., program lead for AHRQ’s Quality Indicators Program. To receive all blog posts, submit your email address.

Examining How Climate Change Affects Health and What the Healthcare Industry Can Do About It

heatImproving diagnostic practices can reduce diseases linked to climate change while also reducing waste and emissions, according to an AHRQ-supported article that examined diagnostic excellence in the context of climate change. The article, published in The American Journal of Medicine, observed that climate change has led to a rise in heat-related illnesses and the spread of diseases, causing worse physical and mental health outcomes. At the same time, the healthcare industry is responsible for about 4.6 percent of global greenhouse gas emissions. Practices like overtesting and overdiagnosis are not only unnecessary but also add to emissions and waste, the authors said. The authors called for a shift in how clinicians approach diagnosis, especially as new or more common diseases emerge due to climate change. Access the article.

Study Examines Effects of Same-Day Follow-Up After an Abnormal Mammogram

mammogramUsing an artificial intelligence–aided interpretation tool for same-day review after an abnormal screening mammogram to reduce patient anxiety increased patient wait times and created higher patient volume in diagnostic centers, according to an AHRQ-funded study published in AMIA Joint Summits of Translational Science. To determine potential consequences of introducing this workflow in a high-volume breast imaging center, the authors conducted a simulation using three days of scheduling data, one year of productivity data and time-motion data obtained during clinic shadowing. They recommended potential ways to mitigate these changes, including extending the operating hours of the imaging center or purchasing new imaging equipment, alongside hiring new technologists. Access the abstract.

Register for Upcoming AHRQ Webinars

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).

AHRQ Research Will Be Highlighted at American Medical Informatics Association Meeting

The American Medical Informatics Association annual meeting in San Francisco, Nov. 9 to 13, will include 30 presentations or posters on AHRQ-funded research. AHRQ grantees will address topics ranging from optimizing artificial intelligence to advancing clinical decision support. AHRQ staff will moderate or participate in panel discussions on the 20th anniversary of AHRQ’s Digital Healthcare Research program, the future of healthcare informatics, digital healthcare equity and efforts to reduce clinician burden. Access more information on AHRQ presentations.

Contribute to AHRQ’s Effective Health Care Program

AHRQ encourages the public to participate in the agency’s Effective Health Care (EHC) Program, which conducts evidence reviews to inform healthcare decision-making on drugs, devices, surgeries and approaches to healthcare delivery. Since 2003, the EHC Program has published more than 300 systematic reviews and 200 research reports along with numerous research methods guides and white papers. These have been used by clinicians, policymakers and patients to inform clinical guidance, coverage decisions and future research. Suggest a research topic, comment on key research questions and draft reports or submit supplemental evidence and data.

Explore Careers at AHRQ

Join the team that strives to improve healthcare for all Americans by investing in health systems research, creating strategies to support practice improvement and providing data and analytics to identify opportunities for improvement. Current vacancies include:

AHRQ in the Professional Literature

Rate of change in cardiac magnetic resonance imaging measures is associated with death in Duchenne muscular dystrophy. Starnes JR, Xu M, George-Durrett K, et al. J Am Heart Assoc. 2024 May 7;13(9):e032960. Epub 2024 Apr 30. Access the abstract on PubMed®.

Life-stage and contextual factors of advance care planning among older adults with limited income. Kimpel CC, Lauderdale J, Schlundt DG, et al. J Appl Gerontol. 2024 Aug;43(8):1144-55. Epub 2024 Feb 13. Access the abstract on PubMed®.

Identifying barriers and facilitators to Veterans Affairs whole health integration using the updated consolidated framework for implementation research. Kimpel CC, Myer EA, Cupples A, et al. J Healthc Qual. 2024 May-Jun;46(3):137-49. Epub 2023 Dec 14. Access the abstract on PubMed®.

Handing off electronic prescription data from prescribers to community pharmacies: a qualitative analysis of pharmacy staff perspectives. Whitaker M, Lester C, Rowell B. J Patient Saf. 2024 Sep 1;20(6):397-403. Epub 2024 May 15. Access the abstract on PubMed®.

Family medicine presence on labor and delivery: effect on safety culture and cesarean delivery. VanGompel EW, Singh L, Carlock F, et al. Ann Fam Med. 2024 Sep-Oct;22(5):375-82. Access the abstract on PubMed®.

The impact of design factors on user behavior in a virtual hospital room to explore fall prevention strategies. Seddighi N, Chen YC, Merryweather AS, et al. HERD. 2024 Jul;17(3):124-43. Epub 2024 Apr 9. Access the abstract on PubMed®.

Exploring home healthcare clinicians' needs for using clinical decision support systems for early risk warning. Xu Z, Evans L, Song J, et al. J Am Med Inform Assoc. 2024 Nov;31(11):2641-50. Access the abstract on PubMed®.

Factors associated with tracheostomy-associated infection treatment: a multicenter observational study. Morrison JM, Kono N, Rush M, et al. Pediatr Pulmonol. 2024 Nov;59(11):2761-71. Epub 2024 Jun 11. 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