President Barack Obama's recess appointment of Harvard Medical School Professor Donald Berwick, MD, to lead the Centers for Medicare & Medicaid Services is drawing praise from healthcare Ieaders across the country who view him as a strong choice for leading the $800 billion agency with more than 90 million enrollees.
"What you have here is someone who is deeply committed to quality and deeply committed to applying whatever lever one can apply to help hospitals deliver safer care and higher quality care and that kind of orientation and aspiration and desire, I think, will be very important and perhaps even transformative for CMS," said John Glaser, vice president and CIO of Partners HealthCare in Boston.
Glaser called Berwick an "intellectual and also bully pulpit leader" who could help change the reimbursement formulas and help focus the healthcare system on "the performance of care rather than the occurrence of care."
Lori Heim, MD, who heads the 94,000-member American Academy of Family Physicians, said Berwick recognizes that a primary care system is critical for achieving needed improvements to the healthcare system at large.
"His support for strengthening primary care in the Medicare and Medicaid systems will help set the path for building up the foundation of all high quality healthcare," she said.
Paul Tang, MD, an internist and vice president and chief medical information officer at the Palo Alto Medical Foundation in Palo Alto, Calif., part of Sutter Health in northern California, said Berwick's "passion, intellect and perseverance make him a perfect person to head up CMS."
"This is an incredible moment in the country's history – a once-in-a-generation opportunity to fundamentally transform the U.S. healthcare system and position it for the future, when 70 million baby boomers become eligible for Medicare," Tang said. "Don's energy and strongly held values will help guide the president's top domestic agenda, and he will do it well."
The White House announced Wednesday that Berwick would start work without Senate confirmation hearings, which is permitted under the Constitution when Congress is on official recess. Under the Constitution, Berwick will be able to serve through the end of the next session of Congress – or the end of 2011.
The White House has accused Congress of stalling Berwick's confirmation hearings and thereby forcing the recess nomination. In response, Republican Senators said the president is making an end-run to avoid disclosing potentially damaging information on Berwick.
Heim dismissed the GOP's argument. She said Berwick is qualified to run CMS, and there can't be further delays, since CMS – an $800 billion agency – has been without an administrator since 2006.
Heim views the choice of Berwick as "ideal," and cites his work as founder and president of the Institute for Health Care Improvement. The institute is well regarded, she said, for focusing on ways of "bringing value to healthcare – improving quality and lowering costs."
Twila Brase, president of the nonprofit advocacy group Citizens' Council on Health Care, questioned Berwick's nomination.
"Dr. Berwick's oft-stated affection for England's socialized medicine system and its rationing body, the National Institute for Clinical Excellence (NICE), is controversial and of great concern to the American people," she said.
Heim discounted claims that Berwick supports rationing. "His history is not one of rationing," she said. "His history is about bringing about quality."
John Halamka, MD, CIO of Beth Israel Deaconess Medical Center in Boston and Harvard Medical School, said Berwick as the best choice for CMS.
"Don is a remarkable leader and visionary," he said. "He is the best person I know to implement the mandates of health reform and improve the quality, safety and efficiency of healthcare in the U.S."