Health Care Matters | May 8
HHS Pushes New Federal Focus on Psychiatric Deprescribing
HHS has launched a new MAHA Action Plan aimed at curbing what the administration describes as psychiatric overprescribing, with a particular focus on children and long-term antidepressant use. The initiative calls for greater use of deprescribing practices, expanded informed consent, and increased emphasis on nonpharmacologic interventions such as psychotherapy, nutrition, and physical activity. At the same time, psychiatrists and mental health leaders are urging caution around how the issue is framed, emphasizing that deprescribing should be individualized, clinically supervised, and balanced against ongoing gaps in mental health access and treatment availability. Clinicians interviewed following the announcement noted that while periodic medication review and deprescribing can be appropriate, there are also significant risks associated with oversimplifying psychiatric treatment or discouraging medication use for patients who benefit from it. Read more here, here and here.
Why It Matters
Mental health and psychiatric care have often been sidelined in broader health policy conversations, so increased attention to prescribing practices, informed consent, and ongoing reassessment of treatment is an important development. At the same time, in a system still facing major access barriers, workforce shortages, and persistent stigma around mental health treatment, the challenge is bigger than reducing unnecessary prescribing alone. Many patients still struggle to access timely, evidence-based care of any kind. As new therapies and treatment approaches continue to emerge, the policy and clinical questions around how to support individualized, effective mental health care are becoming increasingly nuanced. For providers, payers, and policymakers, the path forward will require balancing appropriate oversight with preserving access to the full range of evidence-based treatment options.
CMS Signals Continued Push Toward Electronic Prior Authorization Modernization
CMS recently released new communications and implementation resources focused on electronic prior authorization, reinforcing the agency’s broader interoperability agenda and encouraging stakeholders to accelerate readiness efforts ahead of the January 1, 2027 compliance deadline. The agency’s new overview materials emphasize that impacted payers must implement FHIR-based Prior Authorization APIs, along with related Provider Access and Payer-to-Payer APIs, under the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F). CMS is also expanding its voluntary Health Tech Ecosystem initiative to additional stakeholders, including providers, health systems, EHR vendors, and digital health companies, while continuing to encourage workflow digitization and standards-based interoperability. Read the announcement here.
Why It Matters
There is not a major new policy shift here, but the signal is still important: CMS is continuing to push the industry toward electronic prior authorization as part of its broader interoperability agenda. The core requirement remains the January 1, 2027, deadline for impacted payers to launch prior authorization APIs under CMS-0057-F. What is newer is the continued expansion of the voluntary health tech ecosystem effort and the clear nudge to providers, health systems, EHR vendors, and digital health companies to start building the infrastructure and workflows needed to actually use these APIs. In other words, the payer mandate is coming, but provider readiness will determine whether this meaningfully reduces burden or just creates another layer of technical complexity.
Look for the Helpers: Volunteers Bring Free Care to Uninsured and Underinsured Americans
A recent 60 Minutes feature revisited the work of Remote Area Medical, a nonprofit that operates pop-up clinics providing free medical, dental, and vision care to uninsured and underinsured patients across the country. Supported by hundreds of volunteer clinicians and community members, the organization helps patients access essential care they otherwise could not afford, underscoring both the persistence of access gaps and the impact local volunteers continue to make in communities nationwide. Read here.
What We Are Reading
Choice and Competition Workgroup
The Health Care Payment Learning & Action Network launched a new Choice and Competition Workgroup focused on advancing payment and policy strategies that promote competition, patient choice, and innovation across health care markets. Read here.
Payer-Provider Partnerships in Specialty Care Must Use Health Outcomes as Their North Star
A Health Affairs Forefront article argues that specialty value-based care arrangements will only succeed if payer-provider partnerships are built around measurable health outcomes rather than utilization reduction or short-term cost containment alone. Read here.
Community-Clinical Partnerships and Digital Health for Prevention
A National Academies initiative is exploring how community-clinical partnerships and digital health tools can support CMS Innovation Center prevention strategies focused on chronic disease management and primary care transformation. Read here.
Evidence-Based Prevention Continuum
A new HCPLAN framework outlines how evidence-based preventive interventions can be tested, evaluated, and scaled through payment and delivery reform models designed to support long-term population health improvement. Read here.
The ACCESS Model May Set Off a Health Tech Gold Rush, But New Markets Bring Serious Obstacles
A Health Affairs Forefront article examines how CMS’s ACCESS Model could accelerate adoption of digital health and AI-enabled chronic care tools while also creating challenges related to evidence standards, provider integration, and care fragmentation. Read here.
