Lance's Corner

AHRQ Issues Regulatory Update

Dec 10, 2024

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

December 10, 2024, Issue #941

 

AHRQ Stats: Trends in Severe Maternal Morbidity Complications

Between 2016 and 2021, the rate of delivery stays with respiratory-related severe maternal morbidity (SMM) complications increased 137 percent, the rate of stays with renal-related SMM complications increased 119 percent and the rate of stays with sepsis-related SMM complications increased 54 percent. (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #312, Trends in Severe Maternal Morbidity Complications by Patient Characteristics, 2016-2021.)

Today's Headlines:

New Dashboard Tracks Progress Toward 50 Percent Reduction in Patient and Workforce Harm

dashboardA new online dashboard developed by the National Action Alliance for Patient and Workforce Safety offers a comprehensive resource for understanding the current state of healthcare safety. The National Alliance is a collective effort of federal agencies and private partners led by AHRQ, whose National Advisory Council established a goal of reducing patient and healthcare workforce harm by 50 percent from its pandemic-driven high by 2026. The new dashboard makes national healthcare safety data more transparent and allows for a comprehensive understanding of healthcare safety in different care settings, beginning with hospitals. It also allows policymakers, patient advocates, professional associations, healthcare provider organizations and others to monitor the nation's progress on achieving a vision of safe care everywhere and zero preventable harm for all. Future dashboard expansions will include data on other healthcare settings, such as ambulatory clinics and nursing homes. Access the dashboard and a press release.

Evidence Review Provides New Insights on Diagnosis and Treatment of Obsessive Compulsive Disorders in Children

ocdAn AHRQ evidence review funded by the Patient-Centered Outcomes Research Institute has informed two articles in Pediatrics about diagnosis and management of obsessive compulsive disorders (OCD) in children:
The findings highlight the important lessons researchers are learning after the COVID-19 pandemic about the effectiveness of telehealth.

More Than Three Dozen New Definitions Included in Updated Healthcare Simulation Dictionary

simulationThe new third edition of AHRQ's Healthcare Simulation Dictionary includes 170 definitions of terms ranging from “avatars” and “manikins” to “gamification” and “virtual reality.” Developed by AHRQ and the Society for Simulation in Healthcare, the dictionary standardizes simulation terms in a rapidly expanding field that aims to advance patient safety and improve healthcare delivery. Simulation can provide a safe learning environment for healthcare researchers and practitioners to test new clinical processes and enhance individual and team skills in procedures before touching patients. Examples include inserting ultrasound-guided central venous catheters, diagnosing skin cancer and measuring laparoscopic surgical skills. The updated dictionary includes 41 new terms—including 16 aimed at supporting patient safety efforts—and more than 125 new and revised definitions.

Register Now: Jan. 16 Webinar Will Explore Addressing Health Risks in Older Adults

older adultsAn AHRQ webinar on Jan. 16 from 2 to 3:15 p.m. will explore the role of primary care in optimizing health and well-being for older adults. The event, sponsored by AHRQ’s National Center for Excellence in Primary Care Research, will cover the state of the science around the diagnostic process in older adults, including challenges and recommendations for practice improvement, research and policy to reduce the risk of diagnostic errors. AHRQ-funded researchers will discuss their primary care research on tools and approaches that address risks for cardiovascular events and opioid use in older adults. Register now.

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).

Clinical Decision Support Collaborative Identifies Priorities To Improve Patient and Clinician Decision Making

An article published in Journal of the American Medical Informatics Association Open discusses insights from the May 2023 meeting of AHRQ’s Clinical Decision Support Innovation Collaborative, a community of diverse stakeholders organized and funded by AHRQ’s Digital Healthcare Research Program who use technology to support care teams, patients and caregivers. The collaborative’s meeting brought together more than 70 participants—including healthcare providers, researchers, patients and technology developers—to consider how to advance patient-centered clinical decision support (PC-CDS). The group identified priorities to improve how patients and clinicians make health decisions together. Themes included establishing feedback loops between patients and clinicians, enhancing workflows, expanding research and ensuring health equity. They also explored the potential role of artificial intelligence and considered ways to make PC-CDS scalable. Access the article.

New Research and Evidence From AHRQ

AHRQ in the Professional Literature

Identifying interventions to improve diagnostic safety in emergency departments: protocol for a participatory design study. Seo W, Park SY, Zhang Z, et al. JMIR Res Protoc. 2024 Jun 21;13:e55357. Access the abstract on PubMed®.

Antibiotic use among extremely low birth-weight infants from 2009 to 2021: a retrospective observational study. Flannery DD, Barboza AZ, Mukhopadhyay S, et al. Arch Dis Child Fetal Neonatal Ed. 2024 Jul 20. [Epub ahead of print.] Access the abstract on PubMed®.

Machine learning-augmented interventions in perioperative care: a systematic review and meta-analysis. Mehta D, Gonzalez XT, Huang G, et al. Br J Anaesth. 2024 Dec;133(6):1159-72. Epub 2024 Sep 24. Access the abstract on PubMed®.

Essential advance care planning intervention features in low-income communities: a qualitative study. Kimpel CC, Frechman E, Chavez L, et al. J Pain Symptom Manage. 2024 Sep 24. [Epub ahead of print.] Access the abstract on PubMed®.

Implementation strategies used by facilitators to improve control of cardiovascular risk factors in primary care. Cole AM, Keppel GA, Baldwin LM, et al. J Am Board Fam Med. 2024 Aug;37(3):444-54. Access the abstract on PubMed®.

A model for predicting clinically significant prostate cancer using prostate MRI and risk factors. Lacson R, Haj-Mirzaian A, Burk K, et al. J Am Coll Radiol. 2024 Sep;21(9):1419-27. Epub 2024 May 6. Access the abstract on PubMed®.

Disparities in mentorship and implications for US surgical resident education and wellness. Silver CM, Yuce TK, Clarke CN, et al. JAMA Surg. 2024 Jun;159(6):687-95. Access the abstract on PubMed®.

Establishing data elements and exchange standards to support long COVID healthcare and research. Dolin G, Saitwal H, Bertodatti K, et al. JAMIA Open. 2024 Oct;7(3):ooae095. Epub 2024 Sep 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