The Centers for Medicare & Medicaid Services (CMS) has launched the WISeR Model (Wasteful and Inappropriate Service Reduction) to modernize and streamline Medicare’s prior authorization process. By partnering with tech companies, CMS will test the use of modern tools, such as artificial intelligence, to reduce unnecessary or low-value services that drive up costs and pose risks to patients. The model is limited and focused on certain procedures that are prone to waste or abuse, providing rewards for participants who lower inappropriate utilization and improve decision speed as well as patient experiences. The goal of the WISeR Model is to reduce costs while protecting patient safety, all without changing coverage or restricting provider choice.
To read the CMS Press Release, click here.
To read the CMS Fact Sheet on the WISeR Model, click here.