Cardiac arrests suffered by LeBron James' son Bronny and Buffalo Bills safety Damar Hamlin this year put a public spotlight on a scary heart risk for some young athletes.

• While those high-profile incidents helped drive interest in the use of electrocardiograms (EKGs) in routine physicals for student athletes, experts caution overusing EKGs could create unnecessary risk, Tina writes.

Why it matters: While rare, sudden cardiac death is still the top medical cause of death in athletes. And as millions of teen athletes return to the practice fields in recent weeks, advocates say expanding use of the relatively low-cost, non-invasive intervention could save lives.

• "If you take a screening with just their traditional physical exam and history, you're gonna miss more than 75% of them with underlying disease," said Gul Dadlani, division chief of pediatric cardiology at Nemours Children's Hospital in Orlando.
• Dadlani led a recent study of 11,500 student athletes in central Florida that found about 3% of teens who received an EKG had an abnormal heart finding.

The other side: Despite the rising interest, organizations like the U.S. Preventive Services Task Force and American Academy of Family Physicians recommend against such screening for low-risk individuals without symptoms.

• A spokesperson for the American Heart Association said mandatory EKG screening can "mistakenly suggest a problem that requires more extensive testing to eliminate, and meanwhile, sidelines athletes who aren't actually at risk."

The big picture: In Florida, parents are working with state lawmakers on legislation that would make EKGs for student athletes mandatory. Multiple county school districts already require them.

• If passed, it appears that would be the furthest any state has gone to promote EKGs for student athletes.
• At least 18 states now require that families of student athletes be informed about cardiac arrest and available testing.

Go deeper

Even after employers tried pulling out the stops to bring down the cost of coverage, they're still absorbing some of the biggest increases in a decade this year, Tina writes on a new Mercer survey.

Why it matters: Employers continue to be squeezed by medical inflation at the same time they're fighting to retain workers in a tight labor market.

The big picture: Health coverage per employee has typically risen 3% to 4% a year for the last decade. But the survey of 1,700 employers indicates they saw costs rise more than 5% this year.

• They expect costs to rise 5.4% next year, and note that only changes to benefit design kept the boost from reaching 6.6%.
• There's also more employers with increases above 10% "than we've ever seen," Mercer actuary Sunit Patel told Axios.
• New and pricey drugs, big claims and economic conditions are injecting much more volatility into the picture, Patel said.

What we're watching: How much of the expected increases will get passed along to workers after employers tried to shield them from higher costs in recent years.

• Most large employers told Mercer they do not plan to increase cost-sharing next year.

Keep reading

Health care providers would be explicitly prohibited from making medical decisions that discriminate against people with disabilities under a new rule proposed by the Biden administration, Maya writes.

Why it matters: Unequal treatment in medical settings is still prevalent despite anti-discrimination laws.

• A 2021 survey of physicians found less than half were very confident in their ability to provide an equal level of care to people with disabilities.

Details: The HHS proposal updates nearly 50-year-old regulations on disability protections to clarify that groups receiving federal health care dollars cannot make treatment decisions rooted in biases or stereotypes about people with disabilities.

• Providers would also be required to ensure that patients have reasonable access to medical equipment. For instance, they must be able to help a patient in a wheelchair onto an exam table.

Between the lines: COVID-19 highlighted the ways people with disabilities are discriminated against and treated differently in the American health care system.

• One-third of people who died during the pandemic's first year lived in congregate settings, most of them individuals with disabilities, HHS noted.
• "The one thing COVID did is it created momentum and urgency," said Alison Barkoff, director of the HHS Administration on Community Living.

Presidential advisers recommended the White House create a national patient safety team to help reduce high levels of dangerous care in the medical system, Maya writes.

The big picture: Progress in addressing preventable harms like medication errors and hospital-acquired infections has been "unacceptably slow," necessitating a White House-led initiative to improve patient safety, the President's Council of Advisors on Science and Technology wrote in a report.

The details: The president should appoint a safety coordinator to work across government agencies, as well as a multidisciplinary patient safety team, the report said.

• The team should issue non-binding recommendations that state and federal agencies can then take up.
• The president should also require federal agencies to make a list of high-priority patient safety issues, evidence-based practices and mitigation strategies, as well as a national research agenda.

HIV/AIDS patient advocates are wading into the fight over a federal discount drug program, warning that changes to the program's scope will make it harder for providers to care for those patients.

What's happening: Pharma is lobbying lawmakers for tighter restrictions on the 340B program, arguing that hospitals are improperly profiting from a program meant to help low-income patients — a charge that hospitals deny.

• AIDS United's Public Policy Council, whose membership mostly consists of federally qualified health centers, this week urged policymakers to ensure that 340B providers can continue using drug discounts on all patients who come through their doors, not just low-income or uninsured people.
• The group also called on drugmakers to drop their own restrictions on where 340B providers can use drug discounts and said payers shouldn't penalize providers through extra fees or lower reimbursement.

The intrigue: Some safety-net provider groups, like the National Association of Community Health Centers, have aligned with drugmakers to support tighter curbs in 340B.

🚨 Two state-run veterans homes in New Jersey were unprepared to protect residents from COVID due to widespread dysfunction, DOJ said. (Associated Press)

💻 11 Russian men were charged in connection with a hacker group behind destructive cyber attacks against major hospitals. (NBC News)

🦠 How COVID experts are living with the virus now. (Washington Post)

Meet Bumper (left, age 5) and Bowdie (right, age 2), who live in Michigan with their human, Leah Robinson.

• "They LOVE to weigh in on my Zoom meetings!" Robinson writes about the Pembroke Welsh Corgi siblings.

To see your furry work-from-home colleagues in a future edition of Vitals, send us a picture with their name, age and a brief description.