Berwick Picked to Head Medicare, Medicaid Transition

Obama administration officials have told news organizations that the president plans to nominate Harvard health policy and pediatrics professor Donald Berwick to guide Medicare and Medicaid through the major changes required under the new health care reform law.

Berwick, a longtime advocate for change in the U.S. health care system, would be the first permanent head of the Center for Medicare and Medicaid Services since 2006. If confirmed by the Senate, he’ll be shepherding Medicare and Medicaid — which together provide health coverage for the elderly, poor and disabled — through a turbulent time. Medicaid will be expanded to cover approximately 16 million more people (everyone making up to 133 percent of the federal poverty level) and the new law relies on hundreds of billions of dollars in savings from major changes to the Medicare payment structure.

As head of the 19-year-old Institute for Health Care Improvement in Cambridge, Mass., Berwick focused on working with hospitals to make systematic changes that reduce medical errors, improve the quality of care and reduce cost.

In 2006, the NewsHour profiled Berwick’s “100,000 Lives” campaign to reduce medical errors in hospitals.

Berwick has advocated for reforming the way health care providers are paid to reward quality rather than quantity of care. He’s also a proponent of using evidence-based medicine to find the most effective treatments, and of using electronic health records to improve efficiency and coordination of medical care.

Watch him discuss some of those ideas in these two NewsHour segments.

On electronic health records:

On evidence-based medicine:

The position of CMS administrator is subject to Senate confirmation, and some analysts expect a tough confirmation hearing. Berwick does not have experience managing a large bureaucracy, the New York Times points out.

Sen. Charles Grassley, R-Iowa, ranking Republican on the Senate Finance Committee, released a statement saying: “This is always a big job, but the administration of health care 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. The Finance Committee vetting will need to explore the nominee’s preparedness for the enormous challenges that face the agency.”

It’s also likely that Senators will use the hearings as another forum to debate the policies of health care reform.

“We are in a very politicized time period and the enactment of the bill has not caused a truce,” Robert Blendon, a Harvard professor of health policy and a colleague of Berwick’s, told Business Week. “From the Republican point of view this is not over.”

Kaiser Health News has posted a roundup of blogger reactions to the Berwick nomination, which you can find here.