Medical Daily reported on 28 October that a JAMA study found use of epidural steroid injections fell 15% among traditional Medicare patients after the WISeR prior authorization pilot began in six states in January 2026. Use of other services subject to the approval requirement fell about 20% compared with trends elsewhere in the country. The pilot applies to Original Medicare patients in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington.
Researchers at the University of Minnesota and Brown University compared monthly service use in those states with the rest of the country, using Epic Cosmos electronic health records from the two years before launch and the first six months after it. For epidural steroid injections, the first-quarter 2026 decline was about 21%, against about 9% in the following quarter. Services considered for the pilot but never added showed no significant decline.
Technology companies review requests under the pilot and may use AI to screen them, although a human clinician must review a request before denial. The observational study did not measure patient outcomes or spending. Lead author Hannah Neprash said researchers cannot yet tell whether the care patients did not receive was wasteful or necessary.
