New CMS Chief: Berwick would bring renewed focus to patient safety, quality improvement

Lowering healthcare costs while expanding access has been the talk of the town in Washington, but the chatter circulating today has placed renewed emphasis on patient safety and quality improvement in the wake of news over the weekend that President Obama has nominated longtime quality and patient safety advocate Dr. Donald Berwick to run the Centers for Medicare and Medicaid Services (CMS). Berwick, who is president and CEO of the Institute for Healthcare Improvement (IHI) and a professor of pediatrics and healthcare policy at Harvard Medical School, is considered to one of the leaders in patient safety. 

Dr. Larry Wellikson, CEO of the Society of Hospital Medicine, tells FiercHealthcare that Berwick is a "tireless advocate of the hospitalized patient, quality improvement and the role hospital medicine can play in improving care."

Still, some prediect Berwick's road through the confirmation process will be bumpy. Republicans opposed to health reform are likely to "focus more on [repealing the healthcare reform law] at Berwick's confirmation hearings than on his views," Harvard colleague Robert Blendon tells BusinessWeek.

Expect Berwick's lack of experience running an organization the size of CMS to be an issue. CMS has 4,400 employees and an annual budget of $800 billion, a fact that hasn't escaped Sen. Charles Grassley (R-Iowa), who voted against healthcare reform and will vet Berwick's nomination as part of the Senate Finance Committee.

"This is always a big job," Grassley tells the Wall Street Journal. "[B]ut the administration of healthcare reform, which includes implementing the hundreds of billions of dollars in Medicare cuts and the biggest expansion of Medicaid in its history, will make it more challenging than ever." 

Neither the IHI nor the American Hospital Association, where Berwick served from 1996 through 1999 as an "Independent Member" of the board of trustees, provided comments to FierceHealthcare before our deadline. In a press release, the AHA said it "looks forward to working with the administration to continue finding new ways that hospitals can improve care for the patients and the communities they serve." 

Although he's not particularly known as an avid proponent of healthcare IT, Berwick, as CMS chief, would oversee CMS' implementation of the roughly $25 billion in "meaningful use" Medicare and Medicaid bonus payments for EMR use.

"You can be sure Berwick will work closely with the national coordinator, Dr. David Blumenthal, a fellow Harvard physician, to implement the incentive program," writes Neil Versel, FierceHealthIT senior editor. "Berwick hasn't always been a proponent of health IT, but, as several people have told me over the years, he's been brought, like many other physicians, 'kicking and screaming' into the digital age."

To learn more:
- read this BusinessWeek article
- read this FierceHealthIT editorial
- read the New York Times article
- here's the Health Beat blog post
- check out this Health Affairs blog post
- read this Wall Street Journal article
- read this statement on Berwick's appointment from the MGMA