Medical Economics January 21, 2026
Key Takeaways
- The WISeR model uses AI to reduce wasteful spending in Medicare, focusing on specific procedures in six states.
- Critics argue the model may increase prior authorizations, potentially delaying necessary care and burdening providers.
- Lawmakers introduced the Ban AI Denials in Medicare Act, aiming to stop the WISeR model due to concerns over AI’s role in claim denials.
- Prior authorizations in Medicare Advantage often result in overturned denials, highlighting potential issues with the WISeR model’s approach.
New Medicare payment model aims to take down wasteful spending, but Congress, analysts point out potential problems.
A new Medicare model of value-based payment aims to crack down on waste in health care across six states.
But advocates say it will...
Today's Sponsors
Today's Sponsor