Lance's Corner

AHRQ Issues Regulatory Update

Jun 10, 2025

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

June 10, 2025, Issue #961

 

AHRQ Stats: Annual Expenditures for Diet-Related Health Conditions

Treatment for major diet-related conditions among adults accounted for an average of $334 billion in healthcare expenditures per year during 2021 and 2022. Each adult with these conditions received an average of $3,974 in related care annually. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #561, Expenditures for Key Diet-Related Health Conditions, 2021-2022.)

Today's Headlines:

Researcher Akira Nishisaki Designs Quality Improvement Processes To Reduce Harm in Pediatric ICUs

Akira Nishisaki, M.D., a pediatric critical care physician in the Department of Anesthesiology and Critical Care Medicine at the Children’s Hospital of Philadelphia, has dedicated his career to improving the quality of care and outcomes for critically ill or injured children experiencing respiratory failure, the leading cause of death in infants and children. With funding from AHRQ, Dr. Nishisaki has designed and implemented easily modifiable quality improvement processes that make pediatric airway management safer during tracheal intubation—a common but high-risk procedure that helps with breathing when the airway is blocked or damaged.  

Dr. Nishisaki’s AHRQ research began with the National Emergency Airway Registry for Children (NEAR4KIDS), a quality improvement database that documents outcomes of tracheal intubations based on patient, provider and practice factors. Findings from the NEAR4KIDS database served as the foundation for his future research. Using NEAR4KIDS registry data, Dr. Nishisaki’s team created the airway bundle checklist, a tool medical teams could easily use at the patient’s bedside before, during and after tracheal intubation. Later projects focused on specific quality improvement interventions for procedures that occur during tracheal intubation, including video laryngoscope, apneic oxygenation and bag mask ventilation. All three interventions reduced adverse events and continue to be used throughout the NEAR4KIDS network of pediatric intensive care units (ICUs).  

Dr. Nishisaki’s current grant, Smart Checklist Implementation for Pediatric Tracheal Intubations in the ICU-Multicenter Study: SMART PICU, aims to update and digitize the airway bundle checklist developed with his second AHRQ grant. 

Dr. Nishisaki serves as chair of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, the largest nonprofit pediatric ICU clinical research network. He accredits his successful track record and ability to lead the PALISI network to the support he has received from AHRQ.

Recording of AHRQ’s Listening Session on Public Safety Indicators Now Available

On May 7, AHRQ hosted the Public Listening Session on Opportunities to Update the Patient Safety Indicators, a virtual meeting that gathered more than 700 attendees. Patient Safety Indicators (PSIs) are quality indicators that provide information on potentially avoidable safety events that represent opportunities for improvement in the delivery of care. Speakers from AHRQ, MITRE and UC Davis discussed the history of PSIs and shared interim findings from a gap analysis that aims to identify opportunities for future PSI measurement. Anneliese Schleyer, M.D., M.H.A., a practicing hospitalist and chief medical officer at UW Medicine in Seattle, shared a provider’s perspective on PSI gaps and opportunities. Throughout the session, attendees submitted comments on future PSIs.

Interested stakeholders still have the opportunity to send in feedback through June 27. Visit the website to submit your comments and access the recording and materials for this event.

Medicare Plan Choice Impacts Costs of and Access to Care for Older Adults and Younger Beneficiaries With Disabilities

Two AHRQ-funded studies explore how different types of Medicare coverage impact beneficiaries’ financial and health outcomes:
  • The first study, published in Health Affairs Scholar, examined 3,142 older adults and found that those with a cancer history were more likely to initially select traditional Medicare plus supplemental coverage relative to their counterparts without a cancer history. Compared with selecting traditional Medicare without supplemental coverage, choosing either traditional Medicare with supplemental coverage or Medicare Advantage was associated with lower levels of out-of-pocket spending and a lower probability of fair or poor health.
  • The second study, published in The American Journal of Managed Care, focused on 3,249 beneficiaries aged 50 to 64 with long-term disabilities or other qualifying conditions. It revealed that beneficiaries enrolled in traditional Medicare plus supplemental coverage or Medicare Advantage were less likely than those with traditional Medicare without supplemental coverage to experience access and/or affordability issues, including cost-related medication nonadherence, delayed care or difficulty finding a usual source of care. No significant differences were observed among those also eligible for Medicaid.

New Research and Evidence

Submission Window Open for SOPS® and CAHPS® Databases

  • Surveys on Patient Safety Culture® (SOPS) Data Submission —  Ambulatory surgery centers (ASCs) that administered and collected data for AHRQ’s ASC Survey on Patient Safety Culture between July 2023 and June 2025 are invited to submit data for AHRQ’s SOPS Ambulatory Surgery Center Database from June 2 to June 20. Participating ASCs will receive feedback reports, comparing their results with aggregated, de-identified data from all database participants. Visit the website for the survey and supporting materials and to learn more about database submission. 
  • Consumer Assessment of Healthcare Providers and Systems® (CAHPS) Data Submission — Voluntary data submission for AHRQ’s 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. Learn more about submission requirements and data specifications on the website.

Register for Upcoming Webinars

AHRQ in the Professional Literature

Comparative effectiveness and safety of the JAK Inhibitors and biologic disease-modifying antirheumatic drugs in treating children with nonsystemic juvenile idiopathic arthritis: a Bayesian meta-analysis of randomized controlled trials. Li Y, Huang B, Andorf S, et al. ACR Open Rheumatol. 2025 Feb;7(2):e11788. Access the abstract on PubMed®.

Validity evidence of a resuscitation team leadership assessment measure for use in actual trauma resuscitations. Rosenman ED, Grand JA, Fernandez R. AEM Educ Train. 2025 Apr;9(2):e11061. Epub 2025 Apr 7. Access the abstract on PubMed®.

Use of sensitivity analyses to assess uncontrolled confounding from unmeasured variables in observational, active comparator pharmacoepidemiologic studies: a systematic review. Latour CD, Delgado M, Su IH, et al. Am J Epidemiol. 2025 Feb 5;194(2):524-35. Access the abstract on PubMed®.

Cardiometabolic risk in pediatric patients with intellectual and developmental disabilities. Nolan MB, Asche SE, Barton K, et al. Am J Prev Med. 2025 Mar;68(3):429-36. Epub 2024 Nov 29. Access the abstract on PubMed®.

Assessing methotrexate adherence in juvenile idiopathic arthritis using electronic health record-linked pharmacy dispensing data. Abel D, Anderson D, Kallan MJ, et al. Arthritis Care Res. 2025 Mar;77(3):300-8. Epub 2024 Oct 25. Access the abstract on PubMed®.

Impact of the Affordable Care Act on access to accredited facilities for cancer treatment. Sabik LM, Kwon Y, Drake C, et al. Health Serv Res. 2024 Dec;59(6):e14315. Epub 2024 May 2. Access the abstract on PubMed®.

The Complete Inpatient Record Using Comprehensive Electronic Data (CIRCE) project: a team-based approach to clinically validated, research-ready electronic health record data. Schneider ALC, Ginestra JC, Kerlin MP, et al. Learn Health Syst. 2025 Jan;9(1):e10439. Epub 2024 Jun 18. Access the abstract on PubMed®.

Unsupervised machine learning analysis to identify patterns of ICU medication use for fluid overload prediction. Henry K, Deng S, Chen X, et al. Pharmacotherapy. 2025 Feb;45(2):76-86. Epub 2025 Jan 3. Access the abstract on PubMed®.

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

 

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