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March 28, 2010 01:00 AM

Obama to nominate Berwick to head CMS

the Associated Press
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    Berwick

    An administration official says President Barack Obama will nominate healthcare scholar Donald Berwick to be CMS administrator.

    Berwick, 63, a pediatrician and noted health policy expert, is president and CEO of the not-for-profit Institute for Healthcare Improvement in Cambridge, Mass.

    The timing of the nomination is important because Berwick, if confirmed by the Senate, would take over an agency that has not had a permanent chief executive since Mark McClellan stepped down in the fall of 2006.

    Both Medicare and Medicaid will be undergoing significant changes as part of the healthcare overhaul Obama signed into law days ago.

    The administration official spoke on condition of anonymity because the president has not made his decision public.

    The center's programs serve roughly 100 million people, or 1 in 3 Americans.

    News of the proposed nomination drew quick comment from a leading Senate Republican.

    “This is always a big job,” said Iowa Sen. Chuck Grassley, the senior Republican on the Senate Finance Committee, in a written statement, “but 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. The Finance Committee vetting will need to explore the nominee's preparedness for the enormous challenges that face the agency.”

    In 2009, Berwick was 20th on Modern Healthcare's 100 Most Powerful People in Healthcare ranking and fourth on Modern Healthcare's 50 Most Powerful Physician Executives in Healthcare ranking.

    Berwick is a summa cum laude graduate of Harvard College and a cum laude graduate of Harvard Medical School who also holds a master's degree in public policy from Harvard's Kennedy School of Government. In 1989, he authored "Continuous improvement as an ideal in healthcare," published in the New England Journal of Medicine, which has become a seminal article in the quality improvement movement, advocating the application to healthcare of quality improvement techniques used in other industries.

    Since 1991, Berwick has served as co-founder, president and CEO of the IHI, a not-for-profit that has campaigned for quality improvement efforts in healthcare in the U.S., Canada, Europe and the Middle East. The IHI's 100,000 Lives Campaign reported 3,100 participating hospitals had actually saved an estimated 122,300 lives.

    In 1999, Berwick was given the annual Codman Award by the Joint Commission in recognition of his work in quality improvement.

    Berwick is also a professor of pediatrics and healthcare policy at the Harvard Medical School and a professor of health policy and management at the Harvard School of Public Health.

    An elected member of the Institute of Medicine of the National Academy of Sciences, Berwick served as a member of the IOM's Committee on Quality of Health Care in America, which launched the slowly building revolution in healthcare quality improvement. The committee published in November 1999 To Err is Human: Building a Safer Health System, which gave the healthcare industry one of its most totemic phrases: "At least 44,000, and perhaps as many as 98,000 Americans, die in hospitals each year as the result of medical errors."

    In an interview with Modern Healthcare, Berwick's Harvard colleague and fellow physician researcher Lucian Leape, who helped calculate the oft-quoted death toll from hospital errors, said, "Nothing the IOM has ever done has had the impact of that report."

    A year ago at the American Medical Group Association's annual conference, as the reform political drama was just getting under way, Berwick compared physician performance bonuses to exhortations to do better and said both were “very poor cousins” to healthcare system redesign. He also said the plethora of performance measures need harmonization, and argued for fewer standards and just keeping those that are more reliable in terms of measuring quality. He quoted an African saying about how “Weighing the pig doesn't make it fatter.”

    In his opening keynote speech at that March 2009 conference, Berwick said that anyone who claims the U.S. healthcare system is the best in the world is not looking at the facts.

    --with Modern Healthcare reporting

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