This week’s healthcare roundup includes news about the rollout of a national mental health hotline, a decrease in hospital medical errors, regulatory approach to hospital consolidation and the latest on COVID-19.
Mental health emergencies are fundamentally different from crimes or fires, but until now, most people reporting a mental health crisis have called 911. A national suicide hotline (1-800-273-8255) was first established in 2004. But this number is 10 digits long and hard to remember.
In 2018 Congress passed a bipartisan bill to establish this hotline and the Federal Communications Commission chose 988. Just like 911, the new hotline is usually local, but other regions may handle overflow calls.
This new hotline will meet an important need. Anxiety and depression are up since the beginning of the pandemic, and there are over 3,500 suicides a month. Suicide is currently the tenth leading cause of death and the second leading cause of death among adolescents and young adults. The 988 line will focus on offering easy access to telephonic and in-person treatment for mental illness. Also police are less likely to become involved in calls to the line.
But this new hotline will likely have growing pains. Many states have yet to arrange sustainable financing for 988 call centers, and many of these call centers can’t connect people to the necessary in-person follow-up care because of provider shortages. Also technology used by 911 to pinpoint the caller’s location will not initially be available to 988 call centers, and the 911 and 988 call centers could compete for resources or staff in coming years. Also both services will have to learn to do “warm transfers” as a mental health call sometimes requires police (for instance when a weapon is involved), or an ambulance call sometimes requires mental health assistance.
I’m confident that a dedicated hotline for mental health crisis care can help address real community needs and decrease the suicide rate.
Implications for employers:
The Federal Trade Commission (FTC) blocked four proposed hospital mergers or acquisitions over the last year. This is in line with a presidential executive order issued in July 2021 that ordered federal agencies to “promote competition in the American economy.”
High total healthcare costs in the U.S. are largely driven by high and increasing unit prices. There is overwhelming evidence that consolidation of hospitals leads to higher prices. Also there is some evidence that hospital mergers can lead to decreased quality of care.
Implication for employers:
The Journal of the American Medical Association reported this month that the rate of medical errors in hospitals declined during the 2010s.
The study focused on Medicare beneficiaries, since this data is readily available. Nonetheless, the benefit is likely to extend to those on employer-sponsored health plans, too.
Implications for employers
The White House announced that President Joe Biden tested positive for COVID-19. He is displaying symptoms including fatigue, sore throat and congestion. He has had four vaccines (primary series and two boosters) and is taking Paxlovid. He is likely to recover quickly and fully. This helps demonstrate how common infection is. The President has many domestic and international exposures each week. In addition to vaccination, individuals can protect themselves by masking when indoors, especially in crowded spaces. Employers can reduce risks by increasing the quality of indoor air.
Jeff is an internal medicine physician and has led WTW’s clinical response to COVID-19 and other health-related topics. He has served in leadership roles in provider organizations and a health plan and is an Assistant Professor at Harvard Chan School of Public Health.
