Lance's Corner

AHRQ Issues Regulatory Update

May 6, 2025

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

May 6, 2025, Issue #956


AHRQ Stats: Proportionate Healthcare Expenditures Among High Spenders

Between 2018 and 2022, 21.7 percent of healthcare expenditures were associated with the top 1 percent of spenders. The bottom 50 percent of spenders accounted for less than 3 percent of expenditures. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #560, Concentration of Healthcare Expenditures and Selected Characteristics of People with High Expenses, United States Civilian Noninstitutionalized Population, 2018–2022.)

Today's Headlines:

Kaiser Permanente School of Anesthesia Uses AHRQ’s Surveys on Patient Safety Culture, TeamSTEPPS®

The Kaiser Permanente (KP) School of Anesthesia in Pasadena, Calif., uses AHRQ’s Surveys on Patient Safety Culture (SOPS®) to improve ambulatory care and expand doctoral students’ education. The school has used the SOPS Hospital Survey in the past and recently conducted an analysis of nationwide data from the SOPS Ambulatory Surgery Center Survey. Using the findings, school officials are working to improve patient safety and training for certified registered nurse anesthetists (CRNAs) using TeamSTEPPS.

AHRQ surveys are available for hospitals, medical offices, nursing homes, community pharmacies and ambulatory surgery centers (ASCs). The ASC survey is designed to get feedback from the staff about the culture of patient safety where they work.

“Each year, KP School of Anesthesiology students must complete rigorous projects clinically relevant to nurse anesthesiology,” explained Mark Gabot, D.N.P., CRNA, faculty advisor for the project. “I worked with the hospital SOPS survey a couple of years ago. This time, I wanted to do something on a larger scale. We reached out to AHRQ and were able to get access to the nationwide ASC data for 2021 through 2023. Both certified registered nurse anesthetists (CRNAs) and physician anesthesiologists had completed the surveys,” he said.

The project helped identify strengths and areas for improvement, as well as create best-practice recommendations for patient safety from an anesthesia-informed perspective. After reviewing the data, the team recommended regular use of ASC SOPS and TeamSTEPPS, establishment of a “just culture” for anesthesia practitioners and implementation of a patient safety reporting system.

In response to the project results, the KP School of Anesthesia is improving its TeamSTEPPS training program. “Every year, we conduct TeamSTEPPS training for our students to promote that just culture,” Dr. Gabot said. “Thanks to this project, we’re actually reformatting our TeamSTEPPS approach and education to reflect what the team found in the secondary analysis study.”

 

New AHRQ Toolkit Tackles MRSA and Surgical Site Infections

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most invasive and deadly multidrug-resistant organisms. Preventing MRSA and surgical site infections is a complex patient safety issue that requires a multifaceted effort. AHRQ’s new MRSA Prevention Toolkit: Targeting SSI provides extensive resources, including PowerPoint presentations, facilitator guides, one-page summary documents and staff and patient training materials to help your facility get started or supplement your existing MRSA reduction efforts for cardiac, hip and knee replacement and spinal fusion surgeries.

 

Electronic Clinical Surveillance Identifies Sepsis Antibiotic Overtreatment

Researchers for an AHRQ-funded study in Clinical Infectious Diseases developed a new sepsis overtreatment surveillance metric and subsequently established the validity and usefulness of electronic health record data–derived criteria. The measure identified a 22.5 percent overtreatment in 113,764 adult patients admitted to the emergency department with suspected sepsis who received intravenous antibiotics within three hours of admission without a blood culture sepsis test. Further, the instrument found that 7.6 percent of patients were overtreated and received antibiotics within one hour after admission. The results showed that the average number of antibiotic days, average length of stay and hospitality mortality rate were all higher for patients who received antibiotic overtreatment, and also showed a higher incidence of Clostridioides difficile infection within six months of discharge. Access the abstract.

 

Explore the Latest AHRQ Data on Healthcare Spending on Americans With High Expenses

In 2022, 21.7 percent of healthcare spending was done by the highest 1 percent of spenders. Each year, AHRQ gathers the most up-to-date information on high spenders and makes it available through our data visualization series. Now updated with 2022 statistics, this interactive tool makes it easy to track the most common conditions, demographics, payers and service types associated with high spending. Explore the latest data and check out the highlights in our associated statistical brief.

 

Data Submission Opens for AHRQ CAHPS Health Plan Survey: June 2–27

Voluntary data submission for AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS) Health Plan Survey Database is open from June 2 to June 27. Organizations that administered the CAHPS 5.1 or 5.1H Health Plan Survey between June 29, 2024, and June 27, 2025, are eligible to submit data. The database is accepting submissions for the Adult Medicaid survey, the Child Medicaid or Children’s Health Insurance Program (CHIP) survey without the Children with Chronic Conditions Item Set and the Child Medicaid or CHIP survey with the Item Set. Participating organizations will receive a private feedback report comparing their results with aggregated data from other participants and access to database products that support quality improvement and research. Learn more about submission requirements and data specifications at AHRQ’s CAHPS Database website.

 

Recording of Maternal Health Webinar Now Available

AHRQ’s National Center for Excellence in Primary Care Research Webinar, “The Role of Primary Care in Maternal Health: Factors that Impact Perinatal Care Experience and Outcomes,” held March 6, explored key factors affecting perinatal care. Speakers from Oregon Health & Science University, University of Michigan and Harvard School of Public Health emphasized the need for respectful maternal care. All speakers agreed that better care coordination and communication are critical to improving maternal and infant health outcomes. The panelists answered audience questions on strategies for implementing respectful maternity care training, integrating primary care follow-up into postpartum care models and evaluating the health and economic impacts of Medicaid extension on postpartum outcomes. Access the recording and presenter materials for this event.

 

Register for Upcoming Webinars

  • May 7, 1–2:30 p.m. ET: AHRQ Public Listening Session on Opportunities to Update the Patient Safety Indicators. AHRQ is conducting a gap analysis to identify opportunities to improve and expand Patient Safety Indicators, including into new care settings and populations. This webinar will share the interim findings of the analysis, featuring initial reactions from Sue Sheridan, M.I.M., M.B.A., and Peter Pronovost, M.D., Ph.D. Feedback is welcome from a broad range of stakeholders.
  • May 8, 11–11:30 a.m. ET, and May 14, 2–2:30 p.m. ET: AHRQ Safety Program for HAI Prevention: CLABSI Recruitment Webinars. Learn how participants in the program will receive expert support to prevent infections and promote safety culture.
  • May 13, noon–1 p.m. ET: Implementing CMS’ Patient Safety Structural Measure (PSSM). This webinar from the National Action Alliance for Patient and Workforce Safety will include leaders on the front line of PSSM implementation and delve into tools and resources that support implementation of the five domains of the PSSM: Leadership Commitment, Strategic Planning and Organizational Policy, Culture of Safety and Learning Health System, Accountability and Transparency, and Patient and Family Engagement.

AHRQ in the Professional Literature

Changes in blood pressure, medication adherence, and cardiovascular-related health care use associated with the 2018 angiotensin receptor blocker recalls and drug shortages among patients with hypertension. Callaway Kim K, Roberts ET, Donohue JM, et al. J Manag Care Spec Pharm. 2025 May;31(5):461-71. Access the abstract on PubMed®.

Designing health care provider-centered emergency department interventions: participatory design study. Seo W, Li J, Zhang Z, et al. JMIR Form Res. 2025 Apr 21;9:e68891. Access the abstract on PubMed®.

Between-visit asthma symptom monitoring with a scalable digital intervention: a randomized clinical trial. Rudin RS, Plombon S, Sulca Flores J, et al. JAMA Netw Open. 2025 Apr 1;8(4):e256219. Access the abstract on PubMed®.

Challenges of managing pediatric polypharmacy in a pediatric complex care program: a qualitative pilot study. Reedy J, Thompson T, Begum A, et al. J Am Pharm Assoc. 2025 Mar 22. [Epub ahead of print.] Access the abstract on PubMed®.

NICU parent and staff advocacy to address parental mental health. Klawetter S, Gievers L, McEvoy CT, et al. Clin Pediatr. 2025 Feb;64(2):247-56. Epub 2024 Jun 10. Access the abstract on PubMed®.

Methodology of a social network survey in primary care practices with medical home attributes. Dixon J, Turi E, Pollifrone M, et al. J Ambul Care Manage. 2025 Apr-Jun;48(2):84-94. Epub 2025 Feb 24. Access the abstract on PubMed®.

User-centered design of a preference-driven patient activation tool for optimizing depression treatment in integrated primary care settings (The Transform DepCare Study). Dauber-Decker KL, Serafini MA, Monane R, et al. J Gen Intern Med. 2025 Feb;40(2):556-68. Epub 2024 Jun 4. Access the abstract on PubMed®.

Development of an evidence- and consensus-based Digital Healthcare Equity Framework. Hatef E, Hudson Scholle S, Buckley B, et al. JAMIA Open. 2024 Dec;7(4):ooae136. Epub 2024 Nov 15. Access the abstract on PubMed®.

Contact Information
For comments or questions about AHRQ News Now, contact Karen Fleming-Michael, (301) 427-1798 or Karen.FlemingMichael@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