AI in Healthcare’s Dave Pearson

Digital Health

The Hidden Cost of Mental Health Inequities

Mental health inequities across the US are racking up an annual tab of over $477 billion, and Deloitte’s report on the issue didn’t offer a particularly rosy forecast given our current trajectory.

If left unchecked, Deloitte expects the annual burden to reach $1.3 trillion by 2040, a brutal total considering the “avoidable and unnecessary expenses” behind it.

Drawing on data from government agencies and Komodo Health, the researchers identified four primary cost drivers stemming directly from mental health inequities.

• Avoidable ED utilization resulting from untreated or undertreated mental health conditions. 2024 Expenditures: $5.3B

• Chronic physical conditions linked to mental health’s role as “the invisible counterpart to physical health.” 2024 Expenditures: $23.9B

• Productivity loss due to mental health-related unemployment and missed work days. 2024 Expenditures: $116B

• Premature deaths from suicide, substance use disorders, and mental illness associated with comorbid conditions. 2024 Expenditures: $332.2B

Disadvantaged populations are disproportionately impacted across all four categories due to a “legacy of policies” creating structural inequality, and Deloitte lays out several solutions taking different routes to the same destination: equal access for those who need it most.

• One way to get there is to address the provider shortage by integrating behavioral care with primary care. Not only do PCPs already manage areas like depression, but they’re also experts in the chronic conditions more prevalent among mental health patients. 

• From a regulatory standpoint, Congress should look at reimbursement policies that “create unintended barriers to treatment.” A prime example is Medicaid being “woefully underfunded” to ensure access to care for the 40% of nonelderly beneficiaries with a mental health or substance use disorder.

The Takeaway

If the moral argument for addressing mental health inequities wasn’t enough to inspire action, Deloitte’s business argument should be just as compelling to payors and employers. Although the answers to the problem are obviously easier said than done, the report succeeded in framing up the massive cost of not solving it at all.

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The Wire

• Akili Gets Acquired: A year after pivoting its video game treatment for ADHD to a direct-to-consumer model, Akili Interactive is getting taken private through a merger with under-the-radar DTx company Virtual Therapeutics. Akili shareholders will net about $34M from the transaction, which probably wasn’t the return they were looking for when the company was valued at $1B during its public market debut in 2022. Virtual Therapeutics has kept a surprisingly low profile considering it was a UnitedHealth subsidiary until getting offloaded last year, and there’s little info out there besides the VR mental health treatments on its website.

• Waystar Eyes Public Markets: IPOs are officially back on the menu, with revenue cycle management company Waystar seeking a $3.83B valuation in its upcoming public market debut. Waystar was formed in 2017 through the merger of Navicure and ZirMed, and was initially aiming to IPO last November before getting spooked by the Fed’s “higher for longer” stance on rates. It now joins Tempus AI among the ranks of companies looking to tap into investor’s newfound appetite for public offerings.

• CFO Health Benefit Survey: A Mercer CFO survey highlighted a growing concern over the accelerating rise in health benefit costs, which now average about about $16k per employee. This has become a “significant concern” for 67% of CFOs with over 500 employees, and they believe that future cost management strategies should heavily prioritize areas like clinical management (64%) and high-performance provider networks (48%). About half of the CFOs also reported that their org’s healthcare costs can’t outpace general inflation in order to be sustainable over the next 5 years.

• Innovaccer Quality Management Launch: Innovaccer took the lid off its new quality management and reporting solution tailored specifically for health plans. Arriving right on the heels of Innovaccer’s recent acquisition of PQS, the new solution provides an NCQA-certified platform to address payor challenges in managing care gaps and elevating quality ratings. The lengthy feature list includes a library of 945+ quality measures, a wide array of engagement tools, and integrated end-to-end reporting.

• Mummified Heart Disease: The modern diet and sedentary lifestyle are commonly blamed for our high rates of heart disease, but a recent study shows that CVD was also common 4,000 years ago. Researchers performed CT scans on the mummified remains of 237 adults from seven different global cultures and a range of socioeconomic classes, finding that 37% had atherosclerosis. In addition to being one of most unique studies we’ve covered in a while, these results highlight humans’ innate cardiovascular risks and underscore the need to control modern risk factors.

• LIVEMED Unveils AI Comms Tool: Tech-enabled physician services company LIVEMED Telehealth unveiled its Virtualis clinical communication solution to help providers filter through the noise in their messages. Virtualis leverages AI to prioritize messages based on medical urgency, ensuring critical information can be acted upon swiftly. The solution bolsters LIVEMED’s portfolio of telehealth solutions and its in-house multispecialty physician group to give hospitals a unified platform for virtual care support.

• Physician Background Preferences: Bleeding-edge research in JAMA Network Open found that telehealth patients would rather see their doctor with a professional video background instead of a white sand beach. Researchers polled 1,213 telehealth patients on how different video backgrounds impacted their perception of the physician. Over a third preferred an office that specifically has diplomas on display, 18% preferred a standard physician’s office, and 14% preferred a plain color background. Hard to believe that 2% preferred a kitchen background over any of those.

• Pager and League Tackle Maternity Care: Pager Health is joining forces with League to tackle the maternal mortality crisis with new features aimed at reducing morbidity among expectant and postpartum mothers. Pager’s 360 Enterprise Orchestration solution will be embedded within League’s consumer experience platform, enabling proactive engagement of mothers at critical points to provide access to resources supporting a healthy pregnancy, delivery, and postpartum journey.

• Ransomware’s Local Impact: Ransomware attacks can cause ED visits to spike by upwards of 15% at nearby hospitals that weren’t being targeted, according to a new study in JAMA. Researchers analyzed eight ransomware attacks impacting 15 California hospitals between 2014 and 2020, finding that the targeted hospitals saw ED visits and inpatient admissions fall by 8% within a week of attack, before dropping by 16% in the second week. The coinciding surge for nearby EDs adds more proof that “the consequences of such attacks are broader than the targeted hospitals.”

• PointClickCare + C3HIE: PointClickCare is teaming up with health information exchange C3HIE to deliver a more connected care experience to patients in Texas. Through the partnership, PointClickCare will be bringing C3HIE’s admission, discharge, and transfer data to its care coordination platform, while also adding its expansive library of skilled nursing facility data to the C3HIE network.

• Options for AI Reimbursement: Reimbursement has been one of the major factors limiting broader clinical use of AI, and a new article in JAMA Internal Medicine proposes three revisions to CMS reimbursement policy to foster AI adoption without overburdening Medicare: 1. Bundle AI-enabled services with complementary clinical services. 2. When separate fees are set, use reference pricing to prevent favoritism toward AI firms. 3. Reevaluate CMS reimbursement levels regularly to reflect AI’s impact on the cost of providing a service.

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