Lance's Corner

AHRQ Issues Regulatory Update

Feb 18, 2025

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

AHRQ News Now banner updated 2023

February 18, 2025, Issue #946

 

AHRQ Stats: Transportation Access Among Adults

About 6 percent of U.S. adults reported that a lack of reliable transportation kept them from medical appointments or other important activities for daily living in 2021. In that timeframe, 15.1 percent of those in fair or poor physical health and 17.8 percent of those with fair or poor mental health lacked reliable transportation, far more than those with excellent physical or mental health. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #558, Lack of Reliable Transportation for Daily Living Among Adults: United States, 2021.)

 

Today's Headlines:

New Predictive Model May Help Hospitals Reduce Length of Antibiotic Treatment

More careful use of antibiotics at hospital discharge can help slow the emergence and spread of antibiotic resistance, according to AHRQ-supported research published in Clinical Infectious Diseases. Study authors built a risk-adjusted predictive model for post-discharge length of antibiotic therapy to measure how often and for how long hospitals prescribe antibiotics at discharge. Their review of 1.8 million hospital stays across 129 Veterans Health Administration hospitals from 2018 to 2021 showed that 1 in 5 patients (19.5 percent) received antibiotics at discharge, usually for about seven days. Using the model to compare hospitals, they found 30 percent of hospitals gave fewer antibiotics and shorter treatments than expected; however, 22 percent of hospitals gave antibiotics more often and for longer than needed, suggesting this metric may help hospitals identify opportunities for improved antibiotic stewardship at discharge. Access the abstract.

 

Informational Webinars Scheduled for Hospitals Interested in Reducing Central Line-Associated Bloodstream Infections

AHRQ is seeking acute care hospitals to join a free 9-month program beginning in July to implement strategies to reduce central line-associated bloodstream infections. Participants will receive free expert consultation to promote infection prevention procedures, regular benchmarking reports, guidance on enhancing teamwork and continued education credits. Apply now or register for one of several informational webinars.

 

Addressing Technological Barriers in Pediatric Mental Healthcare in Emergency Departments

An AHRQ-supported study identified 12 technological barriers affecting pediatric mental and behavioral healthcare in pediatric and adult emergency departments. The research published in Applied Ergonomics identified limitations in electronic medical records management, ineffective communication systems in the emergency department, infrastructure inadequacies and insufficient tools for patient engagement among challenges that impact the quality and safety of care. Researchers concluded future research should focus on the barriers while aiming to create design solutions that assist clinicians in their caregiving roles for pediatric mental and behavioral healthcare, focusing on patient safety. Access the abstract.

 

Major Gaps in Electronic Health Records Challenge Alcohol-Related Care in Primary Care

Significant shortcomings in electronic health records (EHRs) used by primary care practices hinder the delivery of evidence-based care for alcohol use disorders (AUD) and unhealthy alcohol use, according to an AHRQ-funded study published in JAMIA Open. An evaluation of 21 EHR systems across 167 practices in seven states found that only 3 percent of practices could generate reports on preventive measures like brief interventions, and just 7 percent could report on treatment initiation and engagement for AUD. These findings highlight critical barriers that limit the ability of primary care providers to address a major public health issue, with alcohol use contributing to over 140,000 U.S. deaths annually. The study emphasizes the need for systemic improvements in EHR functionality to enhance alcohol-related care and offers actionable insights for policymakers, technology developers and healthcare providers. Access the abstract.

 

Penicillin May Be an Effective Treatment for Staph Infections in Kids

An AHRQ-funded study has found that penicillin may be an effective treatment for a small but significant portion of community-acquired skin and soft tissue infections in children caused by methicillin-susceptible strains of Staphylococcus aureus (MSSA). Although penicillin-resistant strains comprised the majority of the infections found in a surveillance study conducted at Texas Children’s Hospital, researchers discovered that 9 percent of infections caused by MSSA could be treated with penicillin. Infections caused by penicillin-susceptible MSSA were associated with higher rates of hospital admission and surgical intervention than those caused by penicillin-resistant strains, highlighting their clinical importance. These findings suggested that it may be time to reconsider penicillin susceptibility testing and treatment options for S. aureus infections in the outpatient setting, particularly as most skin infections are managed outside hospitals. This shift could improve care and reduce reliance on other antibiotics. Access the abstract, in Microbiology Spectrum.

 

March 6 Webinar Highlights Respectful Maternity Care

Factors that Impact Perinatal Care Experience and Outcomes, sponsored by AHRQ’s National Center for Excellence in Primary Care Research, will highlight research on delivering respectful maternity care, insurance disruptions on maternal healthcare and postpartum primary care coordination for people with multiple chronic conditions. The webinar is scheduled for March 6 from 2 to 3:15 p.m. ET.

 

New Research and Evidence From AHRQ

AHRQ in the Professional Literature

Modeling nursing home harms from COVID-19 staff furlough policies. Bartsch SM, Weatherwax C, Leff B, et al. JAMA Netw Open. 2024 Aug;7(8):e2429613. Access the abstract on PubMed®.

Effectiveness of a digital health intervention leveraging reinforcement learning: results from the Diabetes and Mental Health Adaptive Notification Tracking and Evaluation (DIAMANTE) randomized clinical trial. Aguilera A, Arévalo Avalos M, Xu J, et al. J Med Internet Res. 2024 Oct 8;26:e60834. Access the abstract on PubMed®.

Birthing parent perspectives on measuring the quality of perinatal care: metrics, timing, and process. Tully KP. Front Health Serv. 2024 Dec 10;4:1473848. Access the abstract on PubMed®.

A human-centered approach for sharing patient experiences through digital storytelling: a research through design study. Behnam-Asl S, Umstead K, Mahtani R, et al. Des Sci. 2024;10:e23. Epub 2024 Oct 25. Access the abstract on PubMed®.

Machine learning-based infection diagnostic and prognostic models in post-acute care settings: a systematic review. Xu Z, Scharp D, Hobensack M, et al. J Am Med Inform Assoc. 2025 Jan;32(1):241-52. Access the abstract on PubMed®.

New linked employee-employer data show workforce composition is associated with health insurance offers among small employers. Zawacki A, Hegland TA, Keenan PS, et al. Med Care Res Rev. 2025 Feb;82(1):79-87. Epub 2024 Oct 23. Access the abstract on PubMed®.

Trends in short interpregnancy interval births in the United States, 2016-2022. Admon LK, MacCallum-Bridges C, Daw JR. Obstet Gynecol. 2025 Jan;145(1):82-90. Epub 2024 Nov 7. Access the abstract on PubMed®.

Prevent Acute Chest Syndrome checklist (PACScheck): a quality improvement initiative to reduce acute chest syndrome. Morrone K, Strumph K, Pisacano C, et al. Pediatr Blood Cancer. 2025 Jan;72(1):e31378. Epub 2024 Oct 17. 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