Tag Archives: Berwick

Former CMS leader discusses vulnerable populations, drug pricing and a health journalist he admires

Donald Berwick

Don Berwick is a former administrator of the Centers for Medicare and Medicaid Services (CMS) under President Obama. Berwick’s long résumé includes leadership positions at the U.S. Preventive Services Task Force, the National Advisory Council of the Agency for Healthcare Research and Quality, the Institute of Medicine’s Governing Council, the IOM’s Global Health Board, and on President Clinton’s Advisory Commission on Consumer Protection and Quality in the Healthcare Industry. He is president emeritus of the Institute for Healthcare Improvement. He also teaches at Harvard Medical School and is on staff at several major Massachusetts hospitals.

Prior to his keynote address on social determinants of health at the recent Institute for Healthcare Improvement conference in Orlando, Fla., Berwick sat with me to talk about some of today’s most pressing health care issues. [This interview has been edited for clarity and length.] Continue reading

Berwick reminds next class of doctors of their responsibility

Several weeks ago I got an email from a Democrat on the Hill that said, “This might make you cry, right there at your desk.” She attached  an essay by Donald Berwick in the Journal of the American Medical Association.

Berwick

Donald Berwick

I  saved the email but didn’t open it right away. It was a busy day  in a busy month; I’ve heard Berwick speak often, during and after his stint as the head of the Centers for Medicare and Medicaid and when I was lucky enough to attend Institute for Healthcare Improvement conferences and  hear  his soaring, provocative keynotes.  And I had just spoken to him myself a week or so earlier, after the Supreme Court ruling.  I promised myself I’d read this. But later.

August finally arrived, work quieted down (sort of) and as I was trying to slash and delete  my way through the email jungle, I found the Berwick essay.  I clicked.  The person who sent it had been right. I cried right there at my desk.

It was his commencement speech to the graduating class of Harvard Medical School this spring, and it seems on the 40th anniversary of his own HMS graduation.

“You will soon learn a lovely lesson about doctoring; I guarantee it. You will learn that in a professional life that will fly by fast and hard, a hectic life in which thousands of people will honor you by bringing to you their pain and confusion, a few of them will stand out. For reasons you will not control and may never understand, a few will hug your heart, and they will become for you touch points – signposts – like that big boulder on that favorite hike that, when you spot it, tells you exactly where you are. If you allow it – and you should allow it – these patients will enter your soul and you will,  in a way entirely right and proper, love them. These people will be your teachers.”

One of his teachers was a patient he called  Isaiah. Continue reading

Berwick shares thoughts on media coverage of health care, reform

Don Berwick has worked with reporters as part of his jobs at the Institute for Healthcare Improvement and, most recently, at the Centers for Medicare and Medicaid Services.

Berwick appeared at a Newsmaker Briefing at Health Journalism 2011. (Photo: Len Bruzzese)

Having left CMS in December, Berwick agreed to share his thoughts with AHCJ President Charles Ornstein about media coverage of CMS, health reform and his tenure.

Among other things, Berwick says, “There weren’t a sufficient number of longer in-depth analyses of what really was going on and what were the pros and cons of the choices the government, and our nation, are making.”

He also talks about what he calls the “great communication paradox around the Affordable Care Act” – the lack of understanding and explanation of the law.

Among his tips for reporters:

  • Explore the “more care is better care” myth
  • Medicaid is vulnerable and crucial and can’t get enough coverage
  • Stay away from the three-minute soundbite
  • Don’t simply repeat “nonsense”

Read more …

Berwick debuts website featuring health data

By Susan Jaffe, Independent Journalist
From Health Journalism 2011

Journalists have a key role to play making health care safer and informing the public, Medicare chief Donald Berwick told reporters attending the annual conference of the Association of Health Care Journalists in Philadelphia on Thursday.

Donald Berwick

Donald Berwick

To help them do their job, Berwick unveiled a government website, the “Health Indicators Warehouse,” and offered a live demonstration. He said the site offers “a treasure trove of data,” including information never released before in an easily accessible form, including patient safety data, preventive health care indicators, Medicare payment claims and hospital performance at the state and hospital referral region level. Information is searchable by topic, location, health outcomes among other factors.

After highlighting well-publicized features of the Affordable Care Act, Berwick explained how the law provides tools to reduce health care costs that can also improve the quality of care.

“The best way to make care more affordable and sustainable is to make care better,” he said. “Higher quality and lower cost go together.”

To reduce health care costs, he promised continued scrutiny of Medicare Advantage plans, the government-subsidized private health plans, noting that the health law rewards top-performing plans with bonus payments. The law creates accountable care organizations, in which health care providers coordinate patient care in various medical settings. The new Center for Medicare and Medicaid Innovation “can now nurture invention around the country… that have the effect of lowering cost and raising quality.”

Berwick criticized a Republican proposal to use state block grants to replace Medicaid, the state-federal partnership that provides health insurance to low-income families.

“They are untested, they are hazardous,” he said, and could short change states during an emergency. “What happens if we issue a block grant to a state and then there’s a flu outbreak or the recession comes back? Well, you’re on your own.”

During the question and answer period, reporter Jodie Jackson of the Columbia (Mo.) Daily Tribune, had a query related to his reporting that showed a lack of communication about inspection findings between CMS, the FDA and The Joint Commission. After hearing about Jackson’s findings, Berwick said he wanted to read that series of articles.

Berwick spoke for about 90 minutes, without a prepared text, and chatted with individual reporters for another half-hour. It was his second appearance at an AHCJ conference; in 2005, he was key-note speaker when he headed the Institute for Healthcare Improvement, a nonprofit organization dedicated to improving patient care and safety. Unlike his first visit, Berwick did not stay and join AHCJ members in watching a basketball game.