Turn on cookies to sign in
Signing in saves your progress to your Curie account. We can only do that with cookies on — turn them on to continue.
A new Medicare pilot program requiring prior authorization for 41 services — and encouraging AI use in the process — led to notable drops in service utilization. Epidural steroid injections fell 15%, while other targeted services dropped nearly 20%. The big unanswered question: was the care that didn't happen wasteful, or was it actually needed?
A federal pilot program designed to curb fraud, waste, and abuse in Medicare is showing real results — but raising real concerns. The Wasteful and Inappropriate Service Reduction (WISeR) model requires prior authorization for 41 services and actively encourages the use of AI in the approval process. A new study in JAMA, drawing on over 310 million patient records from more than 2,198 hospitals and 49,300 clinics, found that service use dropped significantly in the six states participating in the program.
Researchers from the University of Minnesota and Brown University used a difference-in-differences analysis comparing WISeR states to non-participating states in the two years before launch versus the six months after (January–June 2026).
By the Numbers:
Why it matters: Prior authorization is already one of the most debated tools in healthcare — and adding AI to the mix raises the stakes. While the utilization drops suggest the program is working as intended, researchers caution that it's still unclear whether the reduced care was truly unnecessary or whether patients are being denied services they actually need.
