Discussing WISeR and the Merits of Prior Auths with Jeremy Friese

​Although it’s long been a utilization management strategy for Medicare Advantage, prior authorization has only been used in traditional, fee-for-service Medicare in a very limited way. In fact, that’s often seen as a benefit for patients and their doctors: neither have to deal with an insurer second guessing treatment decisions.

​So when CMMI announced the Wasteful and Inappropriate Service Reduction (WISeR) Model, it sparked backlash and concern from traditional Medicare participants and advocates.

​Now that CMS has selected it’s participants and the first performance year is only a few weeks away, we’re excited to welcome Dr. Jeremy Friese, CEO of Humata Health which is managing the experiment in Oklahoma for a discussion on the WISeR model, Humata’s approach to prior authorization, and the opportunities and challenges bring prior into traditional Medicare.