Departing CMS Administrator's Top Five Accomplishments Highlighted
In Don Berwick era CMS implemented large number of complex, sometimes controversial, rules implementing health reform law; Tavenner takes his job, gets GOP support
Dec. 4, 2011 – Last Friday was Donald Berwick's last day as administrator of the Centers for Medicare & Medicaid
Services. Berwick, a 65-year-old senior citizen, a pediatrician, Harvard professor and well-known quality improvement expert, has served since
President Barack Obama named Dr. Berwick through a recess appointment after it was clear that Senate Republicans would not vote to
confirm him. They said that Berwick's 2008
praise of the British health care system was akin to endorsing government-run
health care which would include rationing.
Under Berwick, CMS developed a large number of complex, and sometimes controversial, rules implementing last year’s
health reform law. While some rules have received mixed reviews, Berwick generally won praise from industry leaders and consumer advocates.
But congressional Republicans criticized him as a symbol of what they see as the Obama administration’s overly-aggressive intervention in the
nation's health care system.
Marilyn Tavenner, previously the number two person at the agency and the former health secretary of Virginia
will now run the agency.
his take on Berwick's top accomplishments.
Obama's Medicare Nominee Tavenner Gets GOP Leader's Support
President Barack Obama's Medicare nominee Tuesday got unexpected support from one of Congress' Republican stars.
Majority Leader Eric Cantor told The Associated Press that Marilyn Tavenner is "eminently qualified" to run Medicare. It may be too soon to
contemplate a truce in the political wars over health care.
With Tavenner, major players on both sides may be able to shift from confrontation
to problem-solving (Alonso-Zalidvar, 11/29).
The Associated Press:
Berwick's Exit Interview With NY Times: 'I Came With An Agenda' For Improvement
The official in charge of Medicare and Medicaid for the last 17 months says that 20 percent to 30 percent of health spending is “waste” that
yields no benefit to patients, and that some of the needless spending is a result of onerous, archaic regulations enforced by his agency. The
official, Dr. Donald M. Berwick, listed five reasons for what he described as the “extremely high level of waste.” They are overtreatment of
patients, the failure to coordinate care, the administrative complexity of the health care system, burdensome rules and fraud (Pear, 12/3).
Meanwhile, Politico unearthed audio of Dr. Berwick's replacement, Marilyn Tavenner.
PoliticoPro: Tavenner: Berwick's Vision Will Continue
No one doubts the managerial skills Marilyn Tavenner brings to her new job as CMS administrator, but many wonder how she will fill Don
Berwick’s shoes as a public ambassador for the administration's policies. ... months before she was nominated by President Barack Obama to
lead CMS, she delivered a rare speech about the Affordable Care Act in March before the Nashville Healthcare Council. ... POLITICO tracked
audio of this rare appearance, which shows that she enthusiastically defends the
ACA (Feder, 12/2).
1.Made CMS less bureaucratic and more responsive.
Berwick conducted the first-ever training to encourage continuous performance improvement throughout the 5,400-employee
agency. He sought to shift the agency culture toward teamwork, innovation, speed, and customer focus. Many staffers say they’ve been energized
and are working to get information out faster to patients and to states, though some complain this work takes up too much of their time.
Berwick also has encouraged staffers to get out into the field more to talk to patients and providers, which staffers say
has been valuable in making policy. Industry experts say CMS has become more open to outside input and is moving faster to make recommended
policy changes that formerly took years.
2.Made CMS a force for U.S. health improvement.
CMS traditionally has focused on administering health care payment policies. But Berwick had broader goals - what he
dubbed the "Triple Aim" to achieve better public health, higher-quality health care and reduced costs. So, he led the drafting of a first-ever
mission statement calling for the agency to be a force for the continual improvement of health and health care for all Americans.
3.Pushed hospitals to improve patient safety.
In April, CMS announced a quintessential Berwick initiative, the $1 billion "Partnership
for Patients" to improve post-hospitalization care. It will test models for reducing nine types of medical errors, including
surgical infections, pressure ulcers and complications from childbirth. The Partnership is patterned on national campaigns Berwick previously
led - as chief of the Institute for Healthcare Improvement - to encourage evidence-based clinical practice. The program will award grants to
partnerships of hospitals and community-based organizations with the goal of reducing hospital-acquired preventable conditions by 40 percent —
and saving 60,000 lives — over the next three years.
4.Started to move Medicare from paying by the procedure to paying based on outcomes.
In October, CMS
unveiled a final rule for a new Medicare demonstration program which advances
accountable care organizations. ACOs are designed to encourage hospitals and physicians to cooperate to provide better, more seamless and less
expensive patient care. If they succeed in delivering quality care for less money, they will share the savings with Medicare.
preliminary ACO shared-savings rule was sharply criticized as unworkable. But
Berwick and his staff won praise from provider groups for producing a final rule that is more likely to get them to participate.
say the projected Medicare savings of less than $1 billion over three years are too small to be significant.
5.Encouraged "innovative" health care delivery models.
The CMS efforts closest to Berwick’s heart are innovative programs to improve patient safety and the delivery of care,
especially for patients with multiple, chronic conditions. The establishment and testing of these demonstration models for better care was
funded by the new Center for Medicare and Medicaid Innovation, which Berwick set up with $10 billion authorized under the health law. Berwick
recruited a respected director, Dr. Richard Gilfillan, from the health insurance industry.
While some experts are optimistic that lessons learned from these projects will keep patients healthier and save billions
of dollars, others say bigger savings are needed faster, and that the history of Medicare demonstration projects leading to effective system
reform is not impressive.
Berwick also launched a project to train and deploy 200 “innovation advisers” in health care facilities around the
country. These part-time quality mentors — who already work as clinicians or administrators and who will be paid up to $20,000 for one year of
service — will spearhead improvement projects in their institutions and communities. They are to be selected from a field of applicants this
For latest version of this story at KHN
You may be eligible for money damages if you owned or leased one of these VW, Porsche or Audi vehicles.
In the major scandal of 2015, Volkswagen cheated you and the world. They rigged diesel emission controls so you, nor regulators, would know how much pollution their cars were adding to our environment.
They were caught and have reserved $7.3 billion to help "make it right" with victims.
If you owned or leased one of these vehicles, contact us now.
Janicek Law attorneys are actively pursuing these cases against VW. Do Not Wait...