Lance's Corner

AHRQ Issues Regulatory Update

Apr 16, 2024

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

April 16, 2024, Issue #909

AHRQ Stats: Distribution of Healthcare Expenditures

In 2021, the top 1 percent of people with high expenses accounted for 24 percent of all healthcare expenditures, while the bottom 50 percent of people with high expenses accounted for less than 3 percent of expenditures. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #556, Concentration of Healthcare Expenditures and Selected Characteristics of Persons With High Expenses, United States Civilian Noninstitutionalized Population, 2018-2021.)

Today's Headlines:

AHRQ Views: New Guide Helps Developers and Users of Digital Healthcare Technologies Advance Equity

equity guideA new AHRQ Views blog post highlights an important addition to the agency’s digital healthcare resources: Digital Healthcare Equity Framework: A Practical Guide for Implementation. The guide, released during National Minority Health Awareness Month, further advances AHRQ’s aim to advance equity via digital healthcare technologies and solutions. In the last 10 years, AHRQ has invested more than $89 million across 153 research projects focused on reducing healthcare disparities. Last November, AHRQ experts presented a research and action agenda for health services research to advance equity in care. AHRQ’s new guide for creating and using digital healthcare technologies and solutions to advance equity has been included among the National Committee for Quality Assurance (NCQA) Equity in Action resources. Access the blog post authored by AHRQ Director Robert Otto Valdez, Ph.D., M.H.S.A.; AHRQ Senior Advisor Kevin Chaney, M.G.S.; and NCQA Director of Health Equity Initiatives Bryan O. Buckley, Dr.P.H., M.P.H., M.B.A. To receive all blog posts, submit your email address.

Researchers Identify Targets To Guide Antibiotic Prescribing by Dentists

dentalAn AHRQ-funded study published in the Journal of Public Health Dentistry identified key facilitators and barriers influencing dentists’ antibiotic prescribing behaviors and found that dentists need improved access to antibiotic prescribing guidelines and additional support in uncertain dental scenarios. A series of interviews conducted with dentists from the U.S. National Dental Practice-Based Research Network explored patient and practice factors perceived to affect antibiotic prescribing. Researchers found many areas for potential intervention to support appropriate and cautious dental antibiotic prescribing, with key broad targets that include increasing visibility and accessibility to current guidelines, providing new guidance to cover unique scenarios, and facilitating better communication with patients and other healthcare providers. Access the abstract.

Webinar on May 2 Will Focuses on Primary Care Workforce Research Methods

Register now for a webinar on May 2 from noon to 1:15 PM ET, Research Methods for Studying the Primary Care Workforce. Sponsored by AHRQ’s National Center for Excellence in Primary Care Research, the webinar will feature three grantees who have developed methodologies to understand the optimal structure and composition of primary care teams and measure the impacts of adding nurse practitioners into primary care. Following presentations in which they describe the primary and secondary data sources used to answer research questions, presenters will be available to answer attendees’ questions.

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).

Apply by April 20 to Serve on AHRQ National Advisory Council

AHRQ is seeking nominations for new members to join its National Advisory Council (NAC), which advises AHRQ’s director and the secretary of Health and Human Services on AHRQ's efforts to fulfill its statutory mission. The agency seeks diverse representation geographically and across priority and underrepresented populations. NAC members meet three times a year. Applicants should submit a résumé and statement of willingness to serve before the June 20 deadline. Self-nominations are accepted. Access more information in the Federal Register Notice and forward questions to Jaime Zimmerman at NationalAdvisoryCouncil@ahrq.hhs.gov.

Register for May 8 Webinar on Feedback Methods To Complement Consumer Assessment of Healthcare Providers and Systems Survey Data

cahpsRegistration is open for a webcast on May 8 from 1 to 2 p.m. ET to highlight how patient experience professionals use multiple patient feedback methods to complement AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS®) data. Speakers will discuss how they use feedback methods with CAHPS results to fully capture patient perspectives and use that information to improve care.

New Research and Evidence From AHRQ

AHRQ in the Professional Literature

Effects of the valsartan recall on heart failure patients: a nationwide analysis. Devine JW, Tadrous M, Hernandez I, et al. Pharmacoepidemiol Drug Saf. 2024 Apr;33(4):e5777. Access the abstract on PubMed®.

Catholic hospital affiliation and postpartum contraceptive care and subsequent deliveries. Meille G, Monnet JN. JAMA Intern Med. 2024 Mar 4. [Epub ahead of print.] Access the abstract on PubMed®.

Assessing an innovative method to promote learning from patient narratives: findings from a field experiment in ambulatory care. Shaller D, Nembhard I, Matta S, et al. Health Serv Res. 2024 Apr;59(2):e14245. Epub 2023 Oct 16. Access the abstract on PubMed®.

The role of human-centered design in healthcare innovation: a digital health equity case study. Levander XA, VanDerSchaaf H, Barragán VG, et al. J Gen Intern Med. 2024 Mar;39(4):690-5. Epub 2023 Nov 16. Access the abstract on PubMed®.

Estimating subgroup effects in generalizability and transportability analyses. Robertson SE, Steingrimsson JA, Joyce NR, et al. Am J Epidemiol. 2024 Jan 8;193(1):149-58. Access the abstract on PubMed®.

Clinical prediction model: multisystem inflammatory syndrome in children versus Kawasaki disease. Starnes LS, Starnes JR, Stopczynski T, et al. J Hosp Med. 2024 Mar;19(3):175-84. Epub 2024 Jan 28. Access the abstract on PubMed®.                             

Impact of hospital affiliation with a flagship hospital system on surgical outcomes. Ramadan OI, Rosenbaum PR, Reiter JG, et al. Ann Surg. 2024 Apr;279(4):631-9. Epub 2023 Oct 17. Access the abstract on PubMed®.

Tools for the diagnosis of ADHD in children and adolescents: a systematic review. Peterson BS, Trampush J, Brown M, et al. Pediatrics. 2024 Apr;153(4):e2024065854. 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