Lance's Corner

AHRQ Issues Regulatory Update

Aug 19, 2025

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

August 19, 2025 | Issue #971

In This Week's Issue: statistical brief on autism care spending; gaps in care for rural patients; safety culture survey for ambulatory surgery centers; webinar recording on patient experience measurement tools

AHRQ Statistical Brief Explores Healthcare Spending for Children With Autism

Just over 1 percent of children aged 3 to 17 were treated for autism spectrum disorder (ASD) annually between 2018 and 2022, and the percentage of boys who were treated was three times that of girls.  A new statistical brief from AHRQ’s Medical Expenditure Panel Survey explores healthcare spending and utilization for children who received treatment for ASD.  Discover how spending varied across service categories, how spending changed as children got older, and how healthcare costs compare with those of children who did not utilize ASD services.

Research Finds Barriers for Rural Patients

Rural Patients Face Growing Travel Times for Surgery

Rural Americans are traveling farther than ever for surgical care, an AHRQ-funded study in JAMA found.  Using Medicare data from over 12 million admissions between 2010 and 2020, researchers examined trends in travel time for 16 common surgical procedures.  The percentage of rural patients traveling more than 60 minutes rose from 37 to 44 percent over that decade.  Median travel times also increased from 43 to 48 minutes for low-risk procedures and from 64 to 69 minutes for high-risk ones.  In contrast, nonrural patients saw much smaller increases.  The greatest growth in travel burden was seen in lower risk surgeries, while some high-risk procedures remained stable.  The findings highlight a widening access gap for rural patients, likely driven by hospital closures, provider shortages, and care centralization.  The trend underscores a growing need for policy and infrastructure solutions.

Rural Pregnant Women Less Likely To Receive Key Ultrasounds

Nearly one in four pregnant women enrolled in Medicaid whose babies were born with serious heart defects did not receive a second-trimester ultrasound, a key prenatal test, according to a study in JACC: Advances funded in part by AHRQ.  Using combined clinical and claims data sets from New York State, researchers linked surgical registry data of 1,506 infants who had heart surgery within 60 days of birth between 2006 and 2019 to their mothers’ Medicaid claims.  They examined prenatal imaging utilization among pregnant women whose babies were born with critical congenital heart defects, and they found that patients living in rural areas were 19 percentage points less likely to receive fetal echocardiograms than those living in nonrural areas.  Access the study.

Celebrating National ASC Month: Unlock SOPS® Resources for Enhanced Patient Safety Culture

In celebration of National Ambulatory Surgery Center (ASC) Month in August, AHRQ honors the vital contributions of ASCs in delivering safe, efficient, and high-quality surgical care to patients across communities and within the broader healthcare system.  In conjunction with this observance, AHRQ encourages ASCs to explore valuable free tools offered by the Surveys on Patient Safety Culture® (SOPS®) Program—including the SOPS ASC Survey, the SOPS ASC Database, and other essential resources.  ASCs may administer the survey at any time.  Also, they may voluntarily submit data to the SOPS ASC Database, at no cost, during designated submission times.  The 2025 ASC Database Report is scheduled for release in October.  The next submission period is scheduled for June 2027.  Findings from the 2023 ASC Database Report showed that only 72 percent of respondents rated staffing, work pressure, and pace favorably; however, most respondents (91%) felt their ASCs actively look for ways to improve patients’ safety, and 85 percent ranked their facilities as “Excellent” or “Very good.”

Recording of CAHPS Tools Webinar Now Available

“New CAHPS Tools for Patient Experience Measurement,” a webinar presented by AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program, highlighted new, innovative tools to enhance patient experience measurement.  The webinar, held June 25, covered the latest surveys in development and newly released surveys, as well as a variety of CAHPS resources designed to support effective survey administration, analysis, and action planning.  The presenters answered audience questions on AHRQ’s role as a research agency, the difference between patient experience and satisfaction, use of approved survey vendors, and the availability and use of CAHPS surveys in other languages.  Access the recording and presenter materials from this event.

Register for Upcoming Webinars

AHRQ Stats: Medical Care Accessibility by Insurance Type

Nationally, 16.5 percent of adults with Medicaid insurance and 18.4 percent of those without insurance considered their access to medical care to be fair or poor in 2021, compared with just 7.6 percent of those on private insurance and 8.4 percent of those on Medicare.  (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #564, Adult Ratings of Neighborhood Medical Care Availability in Nonmetropolitan and Metropolitan Areas, United States 2021.)

New Research and Evidence

AHRQ in the Professional Literature

External validation and update of the pediatric asthma risk score as a passive digital marker for childhood asthma using integrated electronic health records.  Owora AH, Jiang B, Shah Y, et al. EClinicalMedicine. 2025 Jun;84:103254. Epub 2025 May 20.  Access the abstract on PubMed®.

Hospital and skilled nursing facility networks: informal relationships and their role in the placement of traditional Medicare beneficiaries with serious mental illness.  Bucy TI, Maust DT, Cross DA. Health Serv Res. 2025 Aug;60(4):e14465. Epub 2025 Mar 4.  Access the abstract on PubMed®.

Hospice visits and perceived hospice quality among assisted living residents.  Guo W, Cai S, Li Y, et al. J Am Geriatr Soc. 2025 Jul;73(7):2212-9. Epub 2025 May 19.  Access the abstract on PubMed®.

The impact of an enhanced data visualization tool for hypertension in the electronic health record on physician judgments about hypertension control.  Shaffer VA, Wegier P, Valentine KD, et al. J Gen Intern Med. 2025 Jul;40(10):2226-32. Epub 2025 Feb 7.  Access the abstract on PubMed®.

Enrollment in dual-eligible special needs plans and disenrollment rates.  Meyers DJ, Macneal E, Offiaeli K, et al. JAMA Health Forum. 2025 Jul 3;6(7):e251748.  Access the abstract on PubMed®.

Estimating primary care spending in the United States: toward a common method.  Zhan C, Liu L, Simpson M. Med Care. 2025 Jul;63(7):514-9. Epub 2025 May 13.  Access the abstract on PubMed®.

Large language models to summarize pediatric admission notes into plain language.  Ebby CG, Tse G, Bethel J, et al. Pediatrics. 2025 Jun;155(6):e2024069515.  Access the abstract on PubMed®.

Application of algorithm-based treatment approach to low back pain in the emergency department.  Strickland KJ, Kim HS, Seitz AL. Phys Ther. 2025 Apr 2;105(4).  Access the abstract on PubMed®.

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