Lance's Corner

AHRQ Issues Regulatory Update

Apr 22, 2025

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

April 22, 2025, Issue #954

AHRQ Stats: Average Annual Spending on Adult Opioid Prescriptions

Between 2021 and 2022, average annual total outpatient prescription costs for oxycodone totaled $1.9 billion, and costs for hydrocodone totaled $700 million, accounting for nearly 75 percent of the total $3.5 billion spent on all opioid prescriptions among adults. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #559, Average Annual Total Expenses, Total Utilization, and Sources of Payment for Outpatient Prescription Opioids in the U.S. Adult Civilian Noninstitutionalized Population, 2021-2022.)

Today's Headlines:

Addressing Unhealthy Alcohol Use: Resources From AHRQ

April is Alcohol Awareness Month—a time when many health organizations focus on the impact of, and evidence-based treatments for, alcohol use disorder. AHRQ offers research and tools to support clinicians and patients in understanding, identifying and treating unhealthy alcohol use. Explore the resources below to learn more:
  • The EvidenceNOW: Managing Unhealthy Alcohol Use Initiative provides toolkits, implementation guides, workflow examples, quality improvement resources and patient education materials to support alcohol-related care in primary settings. These resources help practices integrate screening, brief intervention and treatment into routine care.
  • The AHRQ Integration Academy’s Unhealthy Alcohol Use Tools and Resources page includes more than 590 tools and materials designed to support primary care practices in managing unhealthy alcohol use. These resources encompass areas such as screening, brief intervention, referral to treatment, medication-assisted treatment, training, patient education and practice implementation, and can be filtered by use, topic, format and audience to suit diverse clinical needs.
  • Interventions for Substance Use Disorders in Adolescents: A Systematic Review synthesizes research on behavioral, pharmacologic and combined interventions for adolescents, age 12 to 20, with problematic substance use or substance use disorder. It includes interventions aimed at achieving abstinence, reducing the quantity and frequency of use, improving functional outcomes and minimizing substance-related harms.
  • Medicines To Treat Alcohol Use Disorder summarizes some of AHRQ’s research for adults who have or think they might have alcohol use disorder. This summary explains what alcohol use disorder is, outlines available medicines to treat it, reviews research on how well those medicines work, describes possible side effects and suggests topics to discuss with a doctor.

Stakeholders Collaborate To Develop Systemwide Solutions to Emergency Department Boarding

An AHRQ-authored article in Health Affairs Scholar highlights the importance of a public-private partnership approach to confront emergency department (ED) boarding. The commentary, written in collaboration with the Centers for Medicare & Medicaid Services, opens a forthcoming featured series in the journal encouraging a multifaceted approach to resolving this critical health system issue. Boarding is the practice of keeping admitted patients in the emergency department because of a lack of available inpatient beds—an operational norm that has been proven to result in increased risk of harm, even death. At AHRQ’s 2024 Summit to Address ED Boarding, 100 key stakeholders from public and private sectors gathered in person, with 695 more participants joining online. Participants collaboratively explored five solution areas for the ED boarding problem: a systemwide approach to incentives and transparency, the use of real-time data, meaningful development of the workforce, attention to the unique problems faced by rural facilities, and a strong connection to primary and behavioral care. Read the agency’s full report of the summit for more details (select Emergency Department Boarding).

 

Data Submission Opens for AHRQ Surveys on Patient Safety Culture® Ambulatory Surgery Center: June 2–20

AHRQ developed the Surveys on Patient Safety Culture (SOPS®) Ambulatory Surgery Center (ASC) Survey in response to interest from ASCs in assessing patient safety culture in their facilities. ASCs that have administered and collected data for AHRQ’s Ambulatory Surgery Center Survey on Patient Safety Culture between July 2023 and June 2025 are invited to submit data for AHRQ’s Surveys on Patient Safety Culture Ambulatory Surgery Center Database from June 2 to June 20. Participating ASCs will receive feedback reports, comparing their results to aggregated, de-identified data from all database participants. Visit AHRQ’s website for the survey and supporting materials and to learn more about database submission.

New Research and Evidence From AHRQ

TeamSTEPPS® Tool Supports Both Patients and Providers

It’s not just healthcare teams who benefit from  AHRQ’s TeamSTEPPS 3.0 curriculum—patients and family caregivers can also get help from a new guide to support self-advocacy and care decisions. Originally designed and developed jointly by AHRQ and the Department of Defense for healthcare teams, TeamSTEPPS is an evidence-based system that helps improve communication and teamwork skills among healthcare professionals to improve patient safety and care. Now a single, modular course, TeamSTEPPS 3.0 includes interactive discussions, exercises, video-based simulations and more to strengthen team skills, reduce communication breakdowns and improve patient care and communication. The updated curriculum was developed with input from experts, patients and caregivers for use by the healthcare team, but it may also be helpful for patients and caregivers as they advocate for themselves or their loved ones. Learn more about how TeamSTEPPS supports healthcare teams or review the Welcome Guide for Patients and Families.

Recording of Safety Culture in Healthcare Webinar Now Available

The webinar Safety Culture in Healthcare: Improving Safety Culture Using Teamwork and Patient Safety Norms, sponsored by the AHRQ-led National Action Alliance for Patient and Workforce Safety, highlighted the importance of safety culture and teamwork in healthcare settings. This webinar, held March 18, was the second of a three-part series on Safety Culture in Healthcare. Experts from Duke University School of Medicine and the University of Michigan discussed how a strong safety culture and effective teamwork are crucial because they significantly impact both patient experience and staff morale. The presenters answered audience questions on TeamSTEPPS and the Comprehensive Unit-based Safety Program (CUSP)—tools that can help create safe, supportive environments for patients and healthcare professionals. Access the recording and presenter materials from this event.

Register for Upcoming Webinars

  • May 1, 2–3:15 p.m. ET: AHRQ Webinar on Approaches To Address the Health of Specific Patient Populations in Primary Care. In this webinar by the National Center for Excellence in Primary Care Research, learn about research on addressing the health needs of specific patient populations in primary care. This includes research to (1) develop community-informed quality measures and implementation strategies for primary care, (2) adapt a transition of care intervention for patients with serious mental illness insured by Medicaid and (3) evaluate a measure of shared decision making for maternity care across demographic groups. Advance registration required.
  • May 7, 1–2:30 p.m. ET: AHRQ Public Listening Session on Opportunities to Update the Patient Safety Indicators. AHRQ is conducting a gap analysis to identify opportunities to improve and expand Patient Safety Indicators, including into new care settings and populations. This webinar will share the interim findings of the analysis, featuring initial reactions from Sue Sheridan and Dr. Peter Pronovost, with feedback welcomed from a broad range of stakeholders.
  • May 8, 11–11:30 a.m. ET: AHRQ Safety Program for HAI Prevention Recruitment Webinar. Learn how participants in the program will receive expert support to prevent infections and promote safety culture.
  • May 13, noon–1 p.m. ET: Implementing CMS’ Patient Safety Structural Measure (PSSM). This webinar from the National Action Alliance for Patient and Workforce Safety will include leaders on the front line of PSSM implementation and delve into tools and resources that support implementation of the five domains of the PSSM: Leadership Commitment, Strategic Planning and Organizational Policy, Culture of Safety and Learning Health System, Accountability and Transparency, and Patient and Family Engagement.

AHRQ in the Professional Literature

An ecological momentary assessment and intervention tool for memory in chronic traumatic brain injury: development and usability of memory ecological momentary intervention. Morrow EL, Nelson LA, Duff MC, et al. JMIR Rehabil Assist Technol. 2024 Nov 26;11:e59630. Access the abstract on PubMed®.

Enhancing pediatric long COVID care through telementoring: insights from an ECHO program. Villatoro C, Henning E, Ng R, et al. Clin Pediatr. 2025 Mar 12. [Epub ahead of print.] Access the abstract on PubMed®.

Improving alcohol-related care in small-medium primary care practices: an evaluation of an adaptation of the SPARC trial intervention for small-medium sized practices. Hamilton LK, Lapham GT, Day A, et al. J Subst Use Addict Treat. 2025 Apr 12. Epub ahead of print.] Access the abstract on PubMed®.

Interdisciplinary systems may restore the healthcare professional-patient relationship in electronic health systems. Cauley MR, Boland RJ, Jr., Rosenbloom ST. J Am Med Inform Assoc. 2025 Jan 17. [Epub ahead of print.] Access the abstract on PubMed®.

A mixed methods study of backup behavior among interprofessional ICU teams. Costa DK, Lee KA, Wright NC, et al. Heart Lung. 2025 May-Jun;71:1-6. Epub 2025 Feb 1. Access the abstract on PubMed®.

Emerging domains for measuring health care delivery with electronic health record metadata. Tawfik D, Rule A, Alexanian A, et al. J Med Internet Res. 2025 Mar 6;27:e64721. Access the abstract on PubMed®.

Enhancing patient engagement and understanding: is providing direct access to laboratory results through patient portals adequate? Lustria MLA, Aliche O, Killian MO, et al. JAMIA Open. 2025 Apr;8(2):ooaf009. Epub 2025 Mar 24. Access the abstract on PubMed®.

Diagnostic stewardship of endotracheal aspirate cultures in hospitalized children with artificial airways: expert consensus statements from the BrighT STAR (Testing STewardship for Antibiotic Reduction) respiratory collaborative. Sick-Samuels AC, Kelly DP, Woods-Hill CZ, et al. Pediatr Crit Care Med. 2025 Apr;26(4):e569-e582. Epub 2025 Feb 12. 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