WATCH NOW: Prior Authorization: Care, Delayed | EP 3

The Healthcare Uncovered Show’s third episode shines a spotlight on prior authorization, exposing how this administrative gatekeeper stalls treatment for patients and adds paperwork headaches for physicians. Guests Dr. Wendy Dean, co‑founder of Moral Injury of Healthcare, Dr. Seth Glickman, former health‑system executive, and Congresswoman Susan DelBene dissect real‑world stories where promised care evaporates under layers of approval, eroding trust and inflating operational costs across the system.

A centerpiece of the conversation is CMS’s new WISER model, the first AI‑powered prior‑authorization engine embedded in traditional Medicare. While proponents tout efficiency gains, the panel argues the algorithm often flags routine services, creating new bottlenecks that delay interventions and compromise outcomes. The discussion references early data showing longer wait times and higher readmission rates, underscoring that technology alone cannot fix a process built on opaque criteria and limited clinician input.

Beyond the technical critique, the episode frames prior‑authorization fatigue as a form of moral injury, where clinicians feel complicit in denying timely care. This psychological toll translates into higher burnout, turnover, and ultimately, higher labor costs for health systems. The guests call for transparent policy reforms, stakeholder collaboration, and a redesign of authorization pathways that prioritize patient safety over administrative convenience. For business leaders, the message is clear: investing in streamlined, clinician‑friendly workflows is not just ethical—it’s a strategic imperative to protect revenue, reputation, and long‑term sustainability.