Lance's Corner

AHRQ Issues Regulatory Update

Apr 15, 2025

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

April 15, 2025, Issue #953

 

AHRQ Stats: Trends in Ventilator-Associated Pneumonia by Hospital Type

Overall, the rate of ventilator-associated pneumonia increased by more than 100 percent between 2019 and 2021 regardless of hospital type. This increase ranged from 133.9 percent at critical access hospitals to 377.7 percent at small hospitals. (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #314, Hospital Differences in Adult Inpatient Stays with Healthcare-Associated Infections, 2019 and 2021.)

Today's Headlines:

Two New Issue Briefs Examine Diagnosis Improvement and Healthcare Excellence

AHRQ has released two new issue briefs on improving diagnosis and healthcare delivery. Exploration of Foundational Terminology and Paradigms for Improving Diagnosis examines varying terms and perspectives that describe successful or failed diagnoses. It provides a historical context for these terms, their pros and cons and usage guidance. Four Pillars for Sustainable Centers of Excellence provides recommendations for Centers of Excellence on how to create sustainability plans that help them to succeed long-term. These centers, part of healthcare organizations, aim to improve care and research on complex topics, such as diagnostic safety. The brief highlights key factors for lasting success, including strong leadership, teamwork and alignment with larger goals.

AHRQ-Funded Study Compares Human and AI-Generated Perspectives on Technology Adoption in Long-Term Care

An AHRQ-funded project explored how different qualitative analysis methods shape our understanding of technology use in long-term and post-acute care. Published in the Journal of Gerontological Nursing, the study asked both human analysts and a ChatGPT-4.0 tool to identify insights from focus group sessions held during the 2024 International Summit on Innovation and Technology for the Care of Older People. While both approaches identified similar themes regarding technology design, ethics, training needs and patient-centered care, human and ChatGPT-based analysis diverged in focus and framing. Human analysts emphasized policy-level determinants, conceptual frameworks and abstract concepts such as humanity, while the ChatGPT analyses offered detailed, technology-centered summaries with practical and future-oriented insights. Approaches that combine human and AI analyses could enhance understanding of challenges and opportunities in technology for older adult care.

New Research and Evidence From AHRQ

Updates to AHRQ Data Resources

In the United States, the top 5 percent of spenders typically account for nearly half of all total healthcare expenditures. A new statistical brief from AHRQ’s Medical Expenditure Panel Survey compares characteristics of these spenders and conditions associated with high spending in 2022 with previous years, highlighting changing trends from 2020 to 2022. AHRQ’s Healthcare Cost and Utilization Project has also released updated data through HCUPNet and HCUP Fast Stats, with tools exploring topics from children’s hospitalizations to severe maternal morbidity all now featuring 2022 data.

Recording of Digital Healthcare Research Program’s AI Tools Webinar Now Available

AHRQ’s Digital Healthcare Research Program hosted the March 18 webinar “Artificial Intelligence Tools to Improve Provider Effectiveness and Patient Outcomes.” Expert panelists from Johns Hopkins University, University of Virginia and University of California, Los Angeles, discussed their research on leveraging artificial intelligence (AI) tools to improve provider effectiveness and patient outcomes in clinical settings. Speakers answered audience questions on ways to get buy-in for placing AI in a provider’s workflow, the most challenging aspects of implementing an AI-informed decision support tool and areas of uncertainty in the AI-informed decision support tool space. Access the recording and presenter materials for this event.

Register for April 21 Informational Webinar on AHRQ Safety Program for HAI Prevention: CLABSI

AHRQ in the Professional Literature

Food security and mental health in the United States: evidence from the Medical Expenditure Panel Survey. McClellan CB, Zuvekas SH. J Ment Health Policy Econ. 2024 Dec 1;27(4):115-28. Access the abstract on PubMed®.

Intravenous antibiotics for urinary tract infections in children with neurologic impairment. Starnes LS, Hall M, Williams DJ, et al. J Hosp Med. 2024 Jul;19(7):572-80. Epub 2024 Apr 1. Access the abstract on PubMed®.

The development and testing of a single-arm feasibility and acceptability study of a whole foods diet intervention for adults with prediabetes and their offspring. Sneed NM, Kelley R, Turner H, et al. Pilot Feasibility Stud. 2024 Oct 23;10(1):130. Access the abstract on PubMed®.

Evaluating the impact of the work environment on job outcomes among registered nurses working in outpatient dialysis centers: a cross-sectional study. Iroegbu C, Lasater KB, Brooks-Carthon M. Nephrol Nurs J. 2025 Jan-Feb;52(1):23-31. Access the abstract on PubMed®.

Integrating out-of-pocket costs into shared decision-making for heart failure with reduced ejection fraction: a stepped-wedge trial (POCKET-COST-HF). Dickert NW, Speight CD, Balser M, et al. Circ Cardiovasc Qual Outcomes. 2025 Jan;18(1):e011273. Epub 2024 Dec 3. Access the abstract on PubMed®.

Availability of behavioral health crisis care and associated changes in emergency department utilization. Burns A, Vest JR, Menachemi N, et al. Health Serv Res. 2025 Apr;60(2):e14368. Epub 2024 Aug 8. Access the abstract on PubMed®.

Comparative effectiveness of buprenorphine adherence with telemedicine vs. in-person for rural and urban patients. Reese TJ, Padi-Adjirackor NA, Griffith KN, et al. J Am Pharm Assoc. 2025 Mar-Apr;65(2):102318. Epub 2024 Dec 27. Access the abstract on PubMed®.

Evaluation of Measure Dx, a resource to accelerate diagnostic safety learning and improvement. Bradford A, Tran A, Ali KJ, et al. J Gen Intern Med. 2025 Mar;40(4):782-9. Epub 2024 Oct 22. Access the abstract on PubMed®.

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