In the first six months of Medicare’s Wasteful and Inappropriate Service Reduction pilot, the use of targeted services fell in participating states relative to the rest of the country, according to a research letter published Oct. 26 in JAMA.
The study, from researchers at the University of Minnesota School of Public Health and Brown University School of Public Health, gives early insights into WISeR. The pilot, which brings AI-enabled prior authorization to traditional Medicare, is taking place for six years across six states, according to CMS.
Compared with trends in other states, monthly epidural steroid injections declined 15%, while other targeted services declined nearly 20%. Services with delayed WISeR implementation served as a negative control, showing no significant change.
The effect was most pronounced right after the launch. For epidural steroid injections, the reduction was roughly 21% in the first quarter of 2026 and dropped to about 9% in the second quarter. The reduction dropped from 21% to 18% for the other services between the quarters.
“The key question we can’t yet answer is whether the care not received was wasteful or necessary,” Hannah Neprash, PhD, lead author and University of Minnesota School of Public Health associate professor, said in an Oct. 26 news release.
WISeR has been met with pushback, particularly from Democratic lawmakers, but is currently continuing.
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