WISeR (Wasteful and Inappropriate Service Reduction) Model

The Wasteful and Inappropriate Service Reduction (WISeR) Model helps protect American taxpayers by leveraging enhanced technologies, such as Artificial Intelligence (AI) and Machine Learning (ML), along with human clinical review, to ensure timely and appropriate Medicare payment for select items and services. The voluntary model encourages care navigation, encouraging safe and evidence-supported best practices for treating people with Medicare. WISeR will run for six performance years from January 1, 2026 to December 31, 2031 in six states: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington.

Key Points
Waste in health care can not only harm patients but also contributes to up to 25% of health care spending in the United States. Wasteful, low-value services often have limited clinical evidence of effectiveness, may not align with an individual’s specific health condition or needs, or can lead to complications and further unneeded services .Solution: The WISeR Model helps reduce clinically unsupported care by working with companies experienced in using enhanced technologies to expedite and improve the review process for a pre-selected set of services that are vulnerable to fraud, waste and abuse. Outcomes: The WISeR Model helps ensure people with Medicare receive the most appropriate care that supports the best health outcomes while decreasing costs and easing administrative burden on providers and suppliers who go through the prior authorization process. Strategy: The WISeR Model empowers patients to partner with their health care providers on the most clinically appropriate care plan; protects the taxpayer by decreasing fraud, waste and abuse; and focuses providers on care that has the most impact on the well-being of people with Medicare.

Key Points

Waste in health care can not only harm patients but also contributes to up to 25% of health care spending in the United States. Wasteful, low-value services often have limited clinical evidence of effectiveness, may not align with an individual’s specific health condition or needs, or can lead to complications and further unneeded services
.Solution: The WISeR Model helps reduce clinically unsupported care by working with companies experienced in using enhanced technologies to expedite and improve the review process for a pre-selected set of services that are vulnerable to fraud, waste and abuse.
Outcomes: The WISeR Model helps ensure people with Medicare receive the most appropriate care that supports the best health outcomes while decreasing costs and easing administrative burden on providers and suppliers who go through the prior authorization process.
Strategy: The WISeR Model empowers patients to partner with their health care providers on the most clinically appropriate care plan; protects the taxpayer by decreasing fraud, waste and abuse; and focuses providers on care that has the most impact on the well-being of people with Medicare.

The Problem with this program, as a voter, is that it is denying American Voters of healthcare using AI strategy.