News and Updates for Healthcare Professionals

The U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine. The Task Force works to improve the health of people nationwide by making evidence-based recommendations about clinical preventive services.

Study is one of the largest to look at the links between sleep quality and COPD flare-ups.

Prediabetes and type 2 diabetes have reached epidemic levels and are associated with major morbidity and mortality. The US Preventive Services Task Force (USPSTF) and the American Diabetes Association (ADA) recently recommended lowering the starting age for diabetes screening to 35 years to facilitate earlier detection and treatment.1,2 We estimated the proportion of asymptomatic US adults eligible for screening based on new vs current USPSTF and ADA screening guidelines, overall and among those with prediabetes or undiagnosed diabetes.

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Cardiovascular disease (CVD) is the leading cause of mortality in the US, accounting for more than 1 in 4 deaths.

Using the 2021 Kidney Disease: Improving Global Outcomes (KDIGO) guideline target of systolic blood pressure (BP) < 120 mm Hg, 66% of adults with chronic kidney disease (CKD) would be eligible for BP lowering, according to a study from South Korea.

Serum sodium levels may help identify adults with a greater chance of experiencing heart disease.

Did you hear? This week, we’re celebrating the 12th anniversary of the Affordable Care Act and the impacts it has had on all Americans.

Hoping to explore the economic burden of heart failure (HF) for both patients and healthcare systems, the Heart Failure Society of America (HFSA) has released a new analysis in the Journal of Cardiac Failure.

For the 19th year, AHRQ is reporting on healthcare quality and disparities. The annual National Healthcare Quality and Disparities Report is mandated by Congress to provide a comprehensive overview of the quality of healthcare received by the general U.S. population and disparities in care experienced by different racial and socioeconomic groups. The report is produced with the help of an Interagency Work Group led by AHRQ.

SDOH Data Collection, Promoting Clinician and Care Team Well-Being, and Measurement of Person-Centered Care Top Priorities to Improve Care for Every Person

WASHINGTON, DC – The National Quality Forum’s (NQF) Leadership Consortium has released its 2022 Priorities for Action. These priorities – rooted in health equity, clinician experience, and patient and caregiver experience – present achievable opportunities for all stakeholders to improve the care experience and health outcomes for every person in America. The Leadership Consortium is a convening of NQF Members that are leaders in the field to connect, collaborate, and share insights on the nation’s most complex healthcare issues.

The Leadership Consortium’s priorities for action build upon NQF’s The Care We Need report and Strategic Plan, which emphasize the need for building a stronger, more focused, and cohesive healthcare quality ecosystem. “Healthcare continues to be presented with unique challenges and opportunities; this year was no different. Given the impact of the pandemic, the importance of setting aligned priorities across the healthcare ecosystem was an imperative. It was a great experience to lead and collaborate with this year’s NQF Leadership Consortium to identify and inform priorities for action that will drive a better healthcare experience for all,” said 2021 Leadership Consortium Chair Dr. Amy Nguyen Howell, Senior National Medical Director, Chief of the Office for Provider Advancement at Optum. The body hosted a webinar for NQF Members earlier this week to share their findings and ideas for the future of healthcare.

Priority One: Social Determinants of Health (SDOH) Data Collection

Health systems recognize the importance of capturing information about the economic and social conditions that influence health. However, studies show a low uptake of coding for these Social Determinants of Health (SDOH) in electronic health records and claims data. There is a need for guidance and standards on the collection of SDOH data elements like food insecurity, housing instability, race, ethnicity, sexual orientation, and gender identity which all impact a person’s ability to successfully navigate the healthcare system. The Leadership Consortium recommends NQF convene multistakeholder experts in a learning collaborative or Action Team to advance the collection and use of SDOH data through the dissemination of emerging and best practices. Healthcare organizations can utilize advancements in SDOH data collection to identify vulnerable patients, assess disparities in care, deliver targeted services, and monitor success in advancing health equity.

Priority Two: Promoting Clinician and Care Team Well-Being

While many healthcare organizations have existing efforts to promote well-being and prevent burnout, few of them know how to best measure clinician wellness. Burnout among clinicians and care teams can have a significant impact on their well-being, morale, and the quality of care being delivered. The COVID-19 pandemic has intensified the physical and mental impacts of providing patient care, and nearly half of healthcare workers have reported burnout amid the pandemic. The Leadership Consortium recommends NQF convene a strategy session with a multistakeholder expert panel to identify measure concepts for the evaluation and improvement of clinician and care team well-being. By measuring and assessing clinician and care team well-being, healthcare stakeholders will be better equipped to identify opportunities to implement viable interventions, measure meaningful change, and improve their well-being and retention.

Priority Three: Measurement of Person-Centered Care

While systems for measuring patient experiences such as AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS) program exist in a variety of care settings, there is widespread consensus that challenges remain in assessing whether care is person-centered. Recent shifts toward care that is person-centered and focused on outcomes have highlighted the importance of measuring the success of high quality care from the perspective of the patient with the goal of improving outcomes, experience of care, and population health. The Leadership Consortium recommends NQF convene multistakeholder experts to identify actionable strategies to address these challenges and better evaluate the delivery of person-centered care. As strategies to implement person-centered care continue to evolve, healthcare leaders should identify measures and measure concepts that incorporate communication, coordination, and shared decision making, and their impact on patient outcomes, as key facets to measuring the success of person-centered care.

NQF convenes the Leadership Consortium annually to identify national health and healthcare priorities for collaboration and coordination. The role of the Leadership Consortium is vital to elevating NQF Member perspectives and the success of NQF’s mission as the trusted voice driving measurable health improvements. NQF encourages all members to sign-up to receive alerts about the Leadership Consortium’s nomination period in early 2022.

The shared decision-making tool could be helpful after the pandemic squashed access to preventive care and opened up deep care gaps.

AHRQ observes Health Literacy Month with a new blog that encourages healthcare organizations to adopt health literacy strategies that can advance Healthy People 2030’s health literacy objectives. Find out about AHRQ’s resources to improve communication and increase shared decision making, including the newly launched Question Builder App in Spanish.

These four videos tell the story of how seven regional Cooperatives worked with more than 5,000 clinicians at over 1,500 small- and medium-sized primary care practices to improve the delivery of heart health services to about 8 million patients.

Starting a daily aspirin regimen in people age 60 or older can cause potentially serious harm including internal bleeding, the USPSTF warned Tuesday.

September 29 is World Heart Day — an observance that aims to improve how we understand, prevent, and manage heart disease. This annual event brings together health organizations across all sectors to turn the spotlight on a condition that each year kills more than 17 million people worldwide.

NIH-supported study underscores the need for racially inclusive approach to address the opioid crisis in hard-hit areas.

Vertebroplasty is probably more effective than sham or usual care for vertebral compression fractures for reducing pain and improving function in older (Medicare-eligible) populations, but benefits are small. Benefits are smaller in sham compared with usual care controlled trials and larger in trials of patients with more acute symptoms.

NIH leadership highlight the results and progress of number strategies to find scientific solutions to address the nation’s opioid crisis.

The U.S. Preventive Services Task Force released today a final recommendation statement on screening for prediabetes and type 2 diabetes. The Task Force recommends screening people ages 35 to 70 with overweight or obesity for prediabetes and diabetes. To view the recommendation, the evidence on which it is based, and a summary for clinicians. The final recommendation statement can also be found in the August 24, 2021 online issue of JAMA.

The urgent need to ensure equity in the American healthcare system is the subject of a new AHRQ Views blog authored by members of AHRQ’s National Advisory Council. The COVID-19 pandemic has starkly illustrated healthcare’s existing racial and ethnic disparities. With that in mind, the blog post’s authors—Edmondo J. Robinson, M.D., M.B.A., Peter J. Embí, M.D., M.S., Ramanathan Raju, M.D., M.B.A., and Yanling Yu, Ph.D.—emphasize the need to level the playing field by pursuing economic and social justice. To do so, we must fully understand the role of social determinants of health in outcomes and equity. Given AHRQ’s strength in healthcare data collection and research, the authors wrote, the Agency is in a perfect position to lead this effort. Only through improved integration and coordinated efforts across health and human services do the authors feel the Nation will create a holistic and equitable health care system for all.

As part of its ongoing efforts to acknowledge, examine, and report on less-explored factors such as social determinants of health, including forms of racism that have resulted in the generational injustices, on August 12 PCD will release an important collection:“ Advancing Health Equity, Eliminating Health Disparities, and Improving Population Health.” Articles appearing in this collection represent 10 papers submitted in response to PCD’s call for papers for the collection, along with 7 articles previously published in the journal. All 17 of these articles underwent the journal’s rigorous peer-review process. In addition, this collection features a position statement on the journal’s commitment to advancing diversity, equity, and inclusion in its scientific leadership, publications, and communication.

Since its establishment in 2004, PCD’s mission has been to promote dialogue among researchers, practitioners, and policy makers worldwide on the integration and application of research findings and practical experience to address health disparities, advance health equity, and improve population health. To be the most successful in this mission requires that PCD adapt to a changing vocabulary and embrace areas of scientific exploration to include not only familiar terms and constructs such as race and ethnicity, health disparities, health inequities, social economic position, and social determinants of health but also all forms of racism, including structural and institutional racism. PCD is well positioned to address chronic disease prevention and health promotion within this changing landscape. This collection, including PCD’s position statement, demonstrates some of the intentional steps the journal has taken to bring attention to these issues. Learn more in the complete PCD collection announcement.

From September 2019 to September 2020, the Centers for Disease Control and Prevention reported nearly 90,000 overdose deaths in the United States. These latest data on the nation’s opioid crisis offer another stark reminder that help is desperately needed in communities across the land. NIH’s research efforts to address the opioid crisis have been stressed during the pandemic, but creative investigators have come up with workarounds like wider use of telemedicine to fill the gap.

Today, the Centers for Medicare & Medicaid Services (CMS) published the Center for Medicare and Medicaid Innovation’s 2020 Report to Congress (RTC). The Innovation Center is required by statute to report to Congress on its activities, at minimum, every other year. This is the Innovation Center’s fifth RTC and covers activities from October 1, 2018 through September 30, 2020. All of the Innovation Center’s Reports to Congress can be found here.

PATIENT IMPACT STATEMENT:

FDA APPROVAL OF KERENDIA TO HELP SLOW KIDNEY DISEASE AND FAILURE ASSOCIATED WITH TYPE 2 DIABETES

WASHINGTON, D.C. – The American Association of Kidney Patients, the largest kidney patient consumer and caregiver organization in the nation, today issued the following statement regarding the recent approval by the U.S. Food and Drug Administration of a new drug therapy, Kerendia by Bayer Pharmaceuticals, designed to slow chronic kidney disease progression and reduce the risk of kidney failure in adult patients with chronic kidney disease associated with type 2 diabetes. Since its founding in 1969, AAKP has been the leading independent and patient-led voice for greater investments and innovations in kidney disease research, detection, and treatment. AAKP is nationally known for its aggressive advocacy on behalf of kidney patient consumers and their right to treatment care choice in consultation with the doctors who they choose to care for them. AAKP defines high-quality kidney care as timely patient access, without interference, to prevention and treatment innovations that empower patients to remain healthy, independent, and able to pursue their aspirations including meaningful work and a career, home ownership, starting and supporting a family, and a secure retirement.

“The American Association of Kidney Patients, as the largest kidney patient organization in the nation, applauds the recent FDA approval of Kerendia because of the substantial medical advancement and hope it represents for kidney patient consumers and their decades-long demand for more innovations to help slow the impacts of chronic kidney disease associated with type 2 diabetes, including loss of kidney function and kidney failure. Kidney disease has an incredibly alarming, growing, and disproportionate impact among minority communities and the burdens and costs are carried by patients, their families, and the American taxpayer. We look forward to informing elected leaders, government agencies, and payers that timely access to this treatment, when determined to be medically beneficial and safe between doctors and their patients, is a priority. Unnecessary interference with these medical determinations or delays with patient access are inconsistent with the principle of patient care choice and the long-standing national goal of advancing innovations and new tools to slow kidney disease, reduce kidney failure, and decrease the number of Americans who may end up on dialysis or the kidney transplant waiting list.”

AAKP works closely with federal government officials, medical researchers, industry leaders, and investors who are committed to re-establishing kidney patient consumers to their rightful place at the center of all kidney health, innovation, research, and policy decisions. The organization provides original kidney patient survey data and expert advice to leaders in government, industry, think tanks, and academia involved in standing up and recruiting patients for research studies, technical evaluation panels, advisory committees, clinical trials, and substantive efforts to include patient insight data across the product development lifecycle—including regulatory and payment decisions.

In 2019, AAKP launched The Decade of the Kidney™, an international patient consortium aimed at mobilizing patient consumers and their allies to push leaders and decision-makers for greater investments in kidney research and more sensible policies to accelerate innovations in kidney drugs, diagnostics, and devices, including artificial kidneys. Since 2019, AAKP, in partnership with The George Washington University School of Medicine and Health Sciences, has conducted The Global Summit on Kidney Disease Innovations (watch 2021 sessions OnDemand here), which has become the largest patient-led and virtual global kidney meeting, engaging over eighty countries and 20,000 viewers in 2021. In 2018, AAKP launched their nonpartisan KidneyVoters™ program, the first voter registration effort for kidney patients, their families, and the broader kidney stakeholder community, including medical professionals. Based on the 2020 success of KidneyVoters™, AAKP has announced plans to register a half million patients and kidney advocates by 2024.

About the American Association of Kidney Patients (AAKP): Founded in 1969, AAKP is the largest kidney patient organization driving policy discussions on kidney patient consumer care choice and treatment innovations. By 1973, AAKP patient collaborations with the U.S. Congress and White House helped gain passage of dialysis coverage for any person suffering kidney failure, creating the only disease specific, taxpayer-funded entitlement program in America. That program, the End Stage Renal Disease Program (ESRD) administered by CMS, has saved over one million lives. In the past decade, AAKP patients have helped gain lifetime transplant drug coverage for kidney transplant recipients (2020); new patient-centered policies via the White House Executive Order on Advancing American Kidney Health (2019); new job protections for living organ donors under the Family Medical Leave Act (FMLA) from the U.S. Department of Labor (2018); and Congressional legislation allowing HIV-positive organ transplants for HIV-positive patients (2013). AAKP virtual platforms and social networks are internationally known for their impact. Follow AAKP on social media at @kidneypatient on Facebook and @kidneypatients on Twitter and visit our website at https://aakp.org/.

AHRQ has developed a new tool to help primary care practices screen and refer patients for social needs such as food or housing, so-called social determinants of health (SDOH) which, when identified, can help tailor care to patients’ circumstances.

It is one of the Tools for Change developed as part of AHRQ’s EvidenceNOW: Advancing Heart Health Initiative, and will be an additional resource on AHRQ’s Social Determinants of Health site.

The tool helps primary care practices:

• Find resources and information to get started on patient screening and referral
• Consider what approaches work best for their practice
• Understand how to use collected information to address patients’ social needs, tailor care to their circumstances, and maximize reimbursement.

You are subscribed to Primary Care Practice-Based Research Networks for Agency for Healthcare Research and Quality (AHRQ). This information has recently been updated, and is now available.

Do you have a patient with a cognitive impairment? Medicare covers a separate visit for a cognitive assessment so you can more thoroughly evaluate cognitive function and help with care planning.

3 Things You Need to Know:

1. If your patient shows signs of cognitive impairment at an Annual Wellness Visit or other routine visit, you may perform a more detailed cognitive assessment and develop a care plan
2. The Cognitive Assessment & Care Plan Services (CPT code 99483) typically start with a 50-minute face-to-face visit that includes a detailed history and patient exam, resulting in a written care plan
3. Any clinician eligible to report Evaluation and Management (E/M) services can offer this service, including: physicians (MD and DO), nurse practitioners, clinical nurse specialists, and physician assistants

Effective January 1, 2021, Medicare increased payment for these services to $282 (may be geographically adjusted) when provided in an office setting, added these services to the definition of primary care services in the Medicare Shared Savings Program, and permanently covers these services via telehealth.

NIH-funded clinical trial improved frailty, depression and overall quality of life.