Sunday, March 28, 2010

Berwick to run Medicare/Medicaid

Unless Republicans in the Senate manage to somehow find a way to sink the nomination, it looks like Don Berwick will be the new Medicare/Medicaid chief. I think that is actually big news. It suggests that in the next phase of healthcare reform, Obama's emphasis will be quality improvement--and likely, linking payment to quality outcomes.

Medicare has already started moving in that direction. And healthcare reform quietly includes some important tools to help it move farther. But this may suggest that Obama is going all in on changing payment structures.

Why do I say that? Because Berwick is the person who has probably best popularized the quality improvement movement within healthcare. Though he runs an institute and has evidently done a good job of it, he is primarily an evangelist, not an administrator. So you wouldn't choose him for a big job unless you thought the job required evangelism.

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