Lance's Corner

AHRQ Issues Regulatory Update

Dec 3, 2024

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

December 3, 2024, Issue #940

 

AHRQ Stats: Trends in Severe Maternal Morbidity

The rate of severe maternal morbidity increased 40 percent between 2016 and 2021, from 72 cases for every 10,000-delivery hospital stays in 2016 to 101.1 per 10,000 in 2021. (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #312, Trends in Severe Maternal Morbidity Complications by Patient Characteristics, 2016-2021.)

Today's Headlines:

AHRQ-Funded Studies Consider Tramadol Use and Safety Trends

Two AHRQ-funded studies offer insight into the use of tramadol, a synthetic opioid medication used for pain management. One article published in Journal of the American College of Cardiology explored the risk of opioid overdose when tramadol is combined with clopidogrel, a common antiplatelet drug. Researchers found a low rate of opioid overdose for patients who initiated tramadol while using antiplatelet therapy, including clopidogrel. A second study published in the American Journal of Preventive Medicine examined tramadol prescription trends from 2005 to 2021, revealing higher use in older adults and women, with an annual decrease in prescriptions following the drug’s 2014 reclassification as a controlled substance.

Due Dec. 9: Letters of Intent for Applicants Seeking To Join Healthcare Extension Service Cooperatives

Letters of intent are due by close of business Dec. 9 for applicants seeking to become one of up to 15 cooperatives in AHRQ’s State-based Healthcare Extension Cooperatives to Accelerate Implementation of Actionable Knowledge into Practice. Letters of intent are not required or binding, and are not considered in application reviews, but they allow AHRQ staff to estimate the potential application workload and plan reviews. Letters of intent should be submitted to AHRQ_HES@ahrq.hhs.gov and include details specified in Section IV of the Notice of Funding Opportunity announcement. To support applicants, AHRQ has provided technical assistance resources and answers to frequently asked questions.

Institutional Learning Networks and Translational Research Drive Pediatric Health Equity Innovations

Two articles from an AHRQ-funded research project present innovative approaches to advancing health equity by drawing from lessons learned in tackling pediatric healthcare disparities. The first article, published in Pediatrics, details the development of the Health Equity Network at Cincinnati Children’s Hospital, which addresses both medical and social determinants of health by implementing targeted interventions to reduce racial disparities in pediatric hospitalizations. Access the abstract. The second publication, a viewpoint in JAMA Pediatrics, introduces the 4Ps Roadmap, an adaptation of a translational research framework, that guides healthcare systems in achieving equitable population health outcomes. These studies underscore the importance of institutional-level approaches and research-driven strategies to address root causes of disparities in healthcare, the authors concluded.

New Data Files Provide Comprehensive View of U.S. Healthcare

AHRQ has released six new files as part of the Compendium of U.S. Health Systems, the foremost public resource for studying characteristics of healthcare organizations over time:
  • The Group Practice linkage files now span 2020-22 and include information on system affiliation, size and billing activity for the nation’s 35,448 group practices. Researchers can now conduct practice-level longitudinal analyses.
  • The Outpatient Site linkage files, which contain street-level information on 279,446 sites, have been updated through 2023. This information complements data on ownership relationships and system affiliations and can be used to classify sites by type, including primary care and behavioral health.
  • The new 2023 Hospital linkage file includes 6,800 hospitals, with data on system affiliation, corporate parents, size and revenue.
  • The System files, the cornerstone of the compendium, now include 2023 data and continue to provide key measures of size, composition, insurance offerings and systemwide hospital revenue for the 639 systems in the compendium.
The Compendium of U.S. Health Systems is a product of AHRQ's Comparative Health System Performance Initiative.

Searchable AHRQ Database Provides Access to Health Services Research Findings

Researchers seeking the latest research on topics ranging from diagnostic safety to primary care to hospital readmissions can find it in AHRQ’s Research Studies database. The database provides more than 10,000 published summaries of journal articles, book chapters and working papers from 2013 to present, including more than 600 publications in 2024. Updated monthly, the resource allows searching by keyword and provides links to journal abstracts. Access the database.

Register for Upcoming AHRQ Webinars

  • Dec. 10, noon to 1 p.m. ET: Resolving Workforce Turnover Crisis will highlight strategies to reduce staff turnover and promote workforce safety in healthcare. The webinar is sponsored by the AHRQ-led National Action Alliance for Patient and Workforce Safety, a public-private collaboration established by AHRQ on behalf of HHS.
  • Dec. 10, 1 to 2 p.m. ET: How Patient Narratives Can Support Your Patient Experience Strategy, sponsored by AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program, will describe how patient narratives can identify and address improvement opportunities.

New Research and Evidence From AHRQ

Pediatric Quality Measures Program 3.0: An Evidence Map of Measures for Vision, Hearing, and Developmental Screening and Followup (draft open for comment)

AHRQ in the Professional Literature

Pediatric mental health care and scope-of-practice expansions. Hughes PM, Graaf G, Gigli KH, et al. Adm Policy Ment Health. 2024 May;51(3):384-92. Epub 2024 Feb 13. Access the abstract on PubMed®.

Evaluating a virtual facilitation workshop with antimicrobial stewardship teams within a cluster randomized stepped-wedge trial. Malone S, Bono K, Saito JM, et al. BMC Health Serv Res. 2024 Oct 21;24(1):1263. Access the abstract on PubMed®.

Medicaid expansion and opioid prescriptions: evidence from the Medical Expenditure Panel Survey. McClellan C, Moriya A. Health Econ. 2024 Nov;33(11):2439-49. Epub 2024 Aug 5. Access the abstract on PubMed®.

Reimagining how we synthesize information to impact clinical care, policy, and research priorities in real time: examples and lessons learned from COVID-19. Gustavson AM, Morrow CD, Brown RJ, et al. J Gen Intern Med. 2024 Oct;39(13):2554-9. Epub 2024 Jun 26. Access the abstract on PubMed®.

Associations of primary care provider burnout with quality improvement, patient experience measurement, clinic culture, and job satisfaction. Quigley DD, Slaughter ME, Qureshi N, et al. J Gen Intern Med. 2024 Jul;39(9):1567-74. Epub 2024 Jan 25. Access the abstract on PubMed®.

Health care utilization in Alaska Native people receiving chronic disease specialty care by videoconsultation compared to propensity-matched controls. Ferucci ED, Arnold RI, Holck P. J Telemed Telecare. 2024 Jul;30(6):941-8. Epub 2022 Jun 22. Access the abstract on PubMed®.

Cost-effectiveness of a primary care-based Healthy Weight Clinic compared with usual care. Sharifi M, Fiechtner LG, Barrett JL, et al. Obesity. 2024 Sep;32(9):1734-44. Epub 2024 Aug 28. Access the abstract on PubMed®.

Diet quality, community food access, and glycemic control among nulliparous individuals with diabetes. Venkatesh KK, Yee LM, Wu J, et al. Prim Care Diabetes. 2024 Oct;18(5):506-10. Epub 2024 Jul 6. 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