Navigating the New WISeR Model in Medicare
The introduction of the WISeR Model by the Centers for Medicare and Medicaid Services (CMS) raises significant concerns for healthcare accessibility. Here’s what you need to know:
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What is WISeR?
This new public-private partnership aims to minimize waste in Medicare by implementing prior authorizations (PAs) for services, heavily relying on AI-driven evaluations by private companies. -
Why it Matters:
93% of physicians report that PAs delay necessary care, while 82% noted patients abandoning recommended treatments due to cumbersome processes. -
Potential Pitfalls:
- Increased Administrative Burden: Physicians may spend up to 13 extra hours weekly on PAs, driving up healthcare costs.
- Profiting from Denials: The model incentivizes companies to maximize denials of care, challenging the spirit of patient-centric healthcare.
As AI and tech enthusiasts, it’s crucial to engage in discussions about the balance between efficiency and patient care.
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