Lance's Corner

AHRQ Issues Regulatory Update

Nov 19, 2024

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

November 19, 2024, Issue #938

AHRQ Stats: Rates of Long COVID by Race

Just 7.3 percent of non-Hispanic Asian adults with a prior COVID-19 infection reported ever having Long COVID as of spring 2023, compared with 14.6 percent of non-Hispanic White adults. (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:

Study Finds Association Between Smoking and Chronic Pain

smokingAlthough smokers represent just 16 percent of the population, they account for nearly one-third of opioid prescriptions and 40 percent of annual morphine-equivalent doses, according to an AHRQ analysis that found a strong connection among smoking, chronic pain and opioid use. The study, an analysis of data from AHRQ’s Medical Expenditure Panel Survey published in Journal of Pain, found that smokers are also significantly more likely to experience chronic pain and start or continue opioid use with stronger opioid dosages. Researchers also found that people who quit smoking show a 20 percent drop in opioid use and a 23 percent reduction in pain within a year, eventually reaching similar pain and opioid-use levels as nonsmokers over time. Integrating smoking cessation programs into pain management could bring lasting relief to people with chronic pain, the authors concluded. Access the abstract.

 

No Clear Link Between Pathogen Type and Severity of Respiratory Infections

coughingInfection type—whether viral, bacterial or mixed—does not significantly influence symptom duration or severity of acute lower respiratory tract infections in outpatient adults, according to an AHRQ-supported study published in Clinical Microbiology and Infection. Researchers tracked more than 700 patients, focusing on cough symptoms, duration and microbiology. Among those tested, 16 percent had viral infections, 34 percent had bacterial infections and 27 percent had mixed infections. Viral or mixed infections were more likely than bacterial infections to cause fever, chills, body aches and general discomfort. The average cough duration ranged from 14 to 17 days across infection types, with viral infections being slightly milder in overall severity. Common pathogens included Haemophilus influenzae and rhinovirus, with SARS-CoV-2 among viral cases. Access the abstract.

 

Apply Now for Funding on Projects To Reduce Healthcare-Associated Infections and Antibiotic Resistance

infectionsAHRQ is seeking research proposals aimed at preventing healthcare-associated infections (HAIs) and for combatting antibiotic-resistant bacteria (CARB). Applications for funding are due Jan. 25, 2025, for demonstration and dissemination projects (R18) and Feb. 5 for large research projects (R01). HAI projects in both grant categories should demonstrate new ways to detect, prevent and reduce HAIs. CARB projects should address ways to promote appropriate antibiotic use, reduce the transmission of resistant bacteria or prevent HAIs. Funding is available for research in all settings: long-term care, ambulatory care, acute care hospitals and those focusing on transitions between care settings. AHRQ encourages research proposals that address inequities in healthcare delivery areas.

 

Dec. 10 Webinar Will Highlight Strategies To Reduce Healthcare Workforce Turnover

turnoverA webinar on Dec. 10 from noon to 1 p.m. ET will highlight strategies to reduce staff turnover and promote workforce safety in healthcare. Turnover among the frontline healthcare workforce continues to impact workforce stability and patient outcomes. The webinar, sponsored by the AHRQ-led National Action Alliance for Patient and Workforce Safety, will feature expert presentations on nurse turnover and its impact on patient care, and evidence-based recommendations for creating environments that support retention and well-being. Access more information about the National Action Alliance, a public-private collaboration established by AHRQ on behalf of HHS. Register for the webinar, access tools and resources to improve care, review previous webinars and subscribe to the initiative’s newsletter.

 

More AHRQ Webinars

  • Dec. 3, 1 to 2 p.m. ET: Person-Centered Care Planning for People With Multiple Chronic Conditions will feature preliminary findings from an AHRQ-funded project on approaches to providing person-centered care for people with multiple chronic conditions. Presenters from Oregon Health & Science University will identify persistent barriers and promising strategies for high-quality care planning. The project was funded by the Patient-Centered Outcomes Research Trust Fund.
  • Dec. 3, 3 to 4:30 p.m. ET: Advancing Digital Healthcare Equity: Navigating Disparities in the Digital Age will explore the intersection of technology, healthcare and equity. The federal expert panel will explore some of the latest frameworks, data and tools to inform and advance health and digital healthcare equity.

 

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

Performance of risk models to predict mortality risk for patients with heart failure: evaluation in an integrated health system. Ahmad FS, Hu TL, Adler ED, et al. Clin Res Cardiol. 2024 Sep;113(9):1343-54. Epub 2024 Apr 2. Access the abstract on PubMed®.

Performance of health care service area definitions for capturing variation in inpatient care and social determinants of health. Crook H, Horta M, Michelson KA, et al. Health Serv Res. 2024 Aug;59(4):e14312. Epub 2024 May 2. Access the abstract on PubMed®.

Effects of Medicaid managed care on early detection of cancer: evidence from mandatory Medicaid managed care program in Pennsylvania. Kwon Y, Roberts ET, Cole ES, et al. Health Serv Res. 2024 Oct;59(5):e14348. Epub 2024 Jul 3. Access the abstract on PubMed®.

Medicare Advantage plan characteristics associated with sorting their beneficiaries to providers that generate fewer avoidable hospital stays. Xu J, Anderson KE, Liu A, et al. Health Serv Res. 2024 Aug;59(4):e14335. Epub 2024 May 29. Access the abstract on PubMed®.

Perception of medication safety-related behaviors among different age groups: web-based cross-sectional study. Lang Y, Chen KY, Zhou Y, et al. Interact J Med Res. 2024 Aug 12;13:e58635. Access the abstract on PubMed®.

Variable impact of medical scribes on physician electronic health record documentation practices: a quantitative analysis across a large, integrated health-system. Florig ST, Corby S, Devara T, et al. J Am Board Fam Med. 2024 Mar-Apr;37(2):228-41. Access the abstract on PubMed®.

Advancing patient-centered clinical decision support in today's health care ecosystem: key themes from the Clinical Decision Support Innovation Collaborative's 2023 Annual Meeting. Dullabh P, Dhopeshwarkar R, Cope E, et al. JAMIA Open. 2024 Dec;7(4):ooae109. Epub 2024 Oct 23. Access the abstract on PubMed®.

Prenatal care clinician preferences among patients with Spanish-preferred language. Butler HM, Bazan M, Rivera L, et al. Obstet Gynecol. 2024 Oct 1;144(4):517-25. Epub 2024 Aug 15. 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