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A Snapshot Of Dr. Berwick’s Successor

Kaiser Health News offers this mini-profile of Mary Tavenner, a former nurse, hospital executive and HHS deputy slated to replace Don Berwick as administrator for the Centers for Medicare and Medicaid Services. Berwick, who resigned due to GOP opposition, will step down later this week. (Here’s a copy of the memo from Health and Human Services Secretary Kathleen Sebelius announcing Tavenner’s appointment.)

Before coming to CMS, Tavenner served as secretary of Virginia’s Health and Human Services where she oversaw 12 agencies that employed 18,000 people. Her career also included 25 years working for the Hospital Corporation of America where she started as a staff nurse and became president of outpatient services, according to an alumni profile posted on the Virginia Commonwealth University’s web site. She has also previously served as acting CMS administrator.

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What Happens If ‘Rock Star’ Berwick Is Out?

I wouldn’t go so far as to call Don Berwick a “rock star.” But here’s Meghan McCarthy, on video for The National Journal, dubbing him a sort of Mick Jagger of Medicaid and speculating on what happens to his loyal fans and groupies of the “quality” health care movement when and if Berwick is timed out of his post as administrator of the Centers for Medicare and Medicaid Services.

She writes:

As Medicare is put under the microscope in the debt-ceiling talks, the clock is running out for Centers for Medicare and Medicaid Services Administrator Donald Berwick to be confirmed by Congress. Berwick took the job of director of CMS in July of last year, getting a recess appointment from President Obama while the Senate was out on break. Republicans have been blocking the confirmation of Berwick, whose controversial academic writings about rationing health care sparked the “death-panel” debate in 2009. If he isn’t confirmed, his term will end in December. So what does that mean for health care policy?

Berwick’s Medicare Job Looking Short-Lived


Donald M. Berwick, the longtime Harvard health care quality guru now heading Medicare and Medicaid, may not have the job for all that long.

Berwick was named by President Obama to lead the Centers for Medicare and Medicaid Services last July in a controversial recess appointment. He has drawn Republican ire ever since, including criticism that he’s too big a fan of the British health care system.

Now, Politico.com reports here that Democrats have given up on winning his confirmation, meaning he’d be out of his job by the end of this year:

Senate Democrats have given up on confirming Don Berwick as CMS administrator in the wake of a letter from 42 Republican senators opposing the nomination, sources tell POLITICO.

Citing the GOP letter, a person familiar with the situation said Senate Democrats and the White House “can do the arithmetic” and now see that there’s no way for Berwick to get the 60 votes needed to clear the Senate.

At a meeting with health care lobbyists Friday, Democratic Senate Finance Committee staffers indicated that the nomination is dead, that there will be no confirmation hearing, and that they’ll soon be discussing “next steps” for CMS, sources said.

In a letter Thursday, 42 GOP senators asked President Barack Obama to withdraw the nomination of Berwick, who received a recess appointment in July and was renominated in January.

Why We Need A TripAdvisor For Hospitals

Whenever I need to book a hotel, I go to TripAdvisor.com first to read other guests’ experiences, from the moldy showers to the bedbugs. In a cogent new commentary in the Journal of the American Medical Association, two Massachusetts doctors write that patients have been slow to start comparing their health care options online for various reasons, and it would help if the hospital world got a Website that would let them share their experiences.

They suggest that the federal Centers for Medicare & Medicaid Services create one, going a step beyond the current site, Hospital Compare. Drs. Tara Lagu and Peter K. Lindenauer, both of Baystate Medical Center and Tufts Medical school, write in part:

A logical next step on the path toward greater transparency and accountability might be for CMS, the single largest payer of physician and hospital services in the United States, to provide the opportunity for all patients to share their inpatient experiences via a patient feedback function that could be added to the Hospital Compare Web site. Additionally, CMS could develop a Web site that would allow patients to write reviews about physician practices.

Note: We wrote about the revamped Massachusetts comparison site, My Health Care Options, here.

Berwick Speaks! (And Tries To Make Peace With A Prickly Health Insurance Lobby)

Since the uproar surrounding Don Berwick’s recess appointment to head the Centers for Medicare and Medicaid, he hasn’t said much — at least not publicly. So today’s speech to, of all people, the health insurance lobby, was a coming out of sorts for the pediatrician and former head of the Cambridge nonprofit, the Institute for Healthcare Improvement.

Here are his full remarks, and a bit of reporting by MedPage Today:

Dr. Don Berwick wants to focus on reducing medical errors


“Let’s look ahead, not back. We have a job to do and we need to make care better for America,” [Berwick] told members of America’s Health Insurance Plans (AHIP), who are in Washington this week for the group’s annual Medicare and Medicaid conference.

Berwick urged the AHIP to work with the federal government to smoothly implement reform and to help make drastic changes to improve the U.S. healthcare system.

But he warned that administration wasn’t interesting in wasting time with “inauthentic” players — groups that they feel are interested in reforming the system, but really want to keep the status quo.

Berwick told the gathering that he wanted to make “healthcare in American as good as it can possibly be. As good as we have every right to expect it to be.”

A major component of that effort, he said, is to focus first on preventing medical errors and drastically improve safety.

“I think it’s time for rededication to safety,” he said. “I propose we aim for an immediate reduction in number of medical injuries.”

Berwick started his speech to the AHIP meeting on a personal note — sharing the story of his father, who spent his career as a general practitioner in a small town in Massachusetts, making house calls, delivering babies, and reading x-rays.

“My father would have laughed if someone called him a medical home,” Berwick said. “Or said he practiced patient-centered care. He would have asked — what other type is there?”

For more on Berwick, there’s a profile in Time, including a story about Dr. Berwick’s own knee surgery, and how it was a catalyst for his quest to improve health care in the U.S.