Lance's Corner

AHRQ Issues Regulatory Update

Feb 20, 2024
The Agency for Healthcare Research and Quality has issued its weekly regulatory update, which can be read below.

AHRQ News Now banner updated 2023

February 20, 2024, Issue #901


AHRQ Stats: Electronic Nicotine Product Use by Age

In 2021, 30.6 percent of adults aged 18 to 24 reported having used an electronic nicotine product, the highest among any age group. By comparison, 25.2 percent of adults aged 25 to 34, 17.9 percent of adults aged 35 to 44, 11.2 percent of those aged 45 to 64 and 4.1 percent of those aged 65 and older reported using electronic nicotine products. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #554, Characteristics of Young Adults Aged 18-24 Who Had Ever Used an Electronic Nicotine Product, 2021.)


Today's Headlines:


AHRQ Views: 20 Years of Innovation From the Digital Healthcare Research Program

The 20th anniversary of AHRQ’s Digital Healthcare Research Program and its support for transforming the fabric of delivering care with groundbreaking discoveries is the subject of a new AHRQ Views blog post. AHRQ has had a foundational role shaping many of today’s modern information systems in healthcare. Over the past 20 years the Digital Healthcare Research Program has been instrumental in demonstrating the effectiveness of telehealthcare, advancing scalable clinical decision support, and enhancing digital healthcare safety. Today, as the program navigates new advances bolstered by additional artificial intelligence tools, AHRQ remains committed to the ethical, equity-focused use of technologies while ensuring that quality and safety remain paramount. Access the blog post authored by AHRQ Director Robert Otto Valdez, Ph.D., M.H.S.A.; Chris Dymek, Ed.D., director of the agency’s Digital Healthcare Research Division; and Kevin Chaney, M.G.S., senior advisor for dissemination and innovation. To receive all blog posts, submit your email address.


Study Highlights Factors Influencing Provider Burnout in Federally Qualified Health Centers

burnoutPressures related to patient care and lower job satisfaction were linked to higher burnout, according to an AHRQ-funded study published in the Journal of General Internal Medicine. Researchers conducted a cross-sectional survey of 143 providers with 74 responding from 44 urban Federally Qualified Health Center clinics, who often experience burnout, to explore the relationship between burnout and perspectives on quality improvement, patient experience, clinic culture, and job satisfaction. They found that about 30 percent of providers reported burnout. Overall, the rate of physician burnout dropped below 50 percent in 2019 for the first time since 2011, but it remains much higher than the burnout rate among U.S. workers in general. They concluded that the creation of environments supporting provider-team relationships and discussions about improving care, along with facilitative leadership, could protect against provider burnout. Access the abstract.

 


Submit Future Research Topics by March 30 to Effective Health Care Program

nominateNominations for new research topics for Effective Health Care (EHC) Program evidence reviews are due March 30. AHRQ encourages the public to participate in the agency’s EHC Program, which conducts evidence reviews to inform healthcare decision-making on drugs, devices, surgeries, and approaches to healthcare delivery. Topic nominations will be reviewed to determine the focus of AHRQ evidence reviews for next fiscal year. Since 1997, the EPC Program has published more than 850 research reports to help:

  • Clinicians and policymakers understand the benefits and harms of different tests and treatments
  • Health systems and policymakers understand the best options for implementing a new program or intervention
  • Patients make better decisions about their healthcare options
  • Inform actions needed to reduce health disparities

Access information about how to submit a research topic or send questions to epc@ahrq.hhs.gov.

 


Webinar: How To Join an AHRQ Program on Improving Antibiotic Use in Telemedicine

webinarRegister now to attend a brief informational webinar to get details on how to join the AHRQ Safety Program for Telemedicine: Improving Antibiotic Use, a no-cost, 18-month national program to strengthen antibiotic prescribing practices. Webinars will be held on several dates in March, April, and May. The program starts in June 2024 and is open to primary and urgent care practices and retail clinics that use telemedicine.

 


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 or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).


Findings Available From 2024 Surveys on Patient Safety Culture® Medical Office Database

Results from AHRQ’s Surveys on Patient Safety Culture® (SOPS®) Medical Office: 2024 User Database Report are now available. The 2024 Report includes a description of the findings and two appendices, presenting data by medical office characteristics (number of providers, single specialty vs. multispecialty, primary care specialty, specific specialty, ownership, and geographic region) and respondent characteristics (staff position and tenure in medical office).


New Research and Evidence From AHRQ


AHRQ in the Professional Literature


Decision-making during high-risk events: a systematic literature review. Reale C, Salwei ME, Militello LG, et al. J Cogn Eng Decis Mak. 2023 Jun;17(2):188-212. Epub 2023 Jan 17. Access the abstract on PubMed®.

Guideline concordance and antibiotic-associated adverse events between Veterans Administration and non-Veterans Administration dental settings: a retrospective cohort study. Ramanathan S, Evans CT, Hershow RC, et al. Front Pharmacol. 2024 Jan 16;15:1249531. Access the abstract on PubMed®.

Infant health care disruptions by race and ethnicity, income, and insurance during the COVID-19 pandemic. Eliason EL, Agostino J, Vivier P. Acad Pediatr. 2024 Jan-Feb;24(1):105-10. Epub 2023 Jul 23. Access the abstract on PubMed®.

Impact of social needs case management on use of medical and behavioral health services: secondary analysis of a randomized controlled trial. Fleming MD, Guo C, Knox M, et al. Ann Intern Med. 2023 Aug;176(8):1139-41. Epub 2023 Aug 8. Access the abstract on PubMed®.

An mHealth design to promote medication safety in children with medical complexity. Jolliff A, Coller RJ, Kearney H, et al. Appl Clin Inform. 2024 Jan;15(1):45-54. Epub 2023 Nov 21. Access the abstract on PubMed®.

Hospital-physician integration and clinical volume in traditional Medicare. Post B, Hollenbeck BK, Norton EC, et al. Health Serv Res. 2024 Feb;59(1):e14172. Epub 2023 May 29. Access the abstract on PubMed®.

Seeing things the same way: perspectives and lessons learned from research-design collaborations. Mangal S, Berger L, Bruzzese JM, et al. J Am Med Inform Assoc. 2024 Jan 18;31(2):542-7. Access the abstract on PubMed®.

Social determinants of health documentation in structured and unstructured clinical data of patients with diabetes: comparative analysis. Mehta S, Lyles CR, Rubinsky AD, et al. JMIR Med Inform. 2023 Aug 22;11:e46159. 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