Will Berwick survive at CMS?

Bob Wachter’s latest post gives me some (slim) hope that my earlier post about Berwick’s tenure at CMS being over was premature. Read for yourself—it seems like a double-bank shot to me, and the “political zombie” argument is a more plausible explanation for some of his recent statements. But who knows?

Berwick is out

Looks like Don Berwick’s tenure at CMS will be a short one, since the votes to confirm him are not there. We commented here on his initial recess appointment. I can’t comment much more without making this a political blog, which has never been our intent. I will only say that it is a sad commentary on the state of our divided government, and yet another setback for efforts to improve the U.S. healthcare system. As for a replacement: who in their right mind would want to step into this arena now, to have their record judged by people whose primary goal is the failure of healthcare reform?

More troubles for Berwick?

Much of the recent criticism aimed at Don Berwick, the new CMS Administrator, is, in my opinion, unfair and politically motivated. Other criticism is legitimate, as some in the quality and infection prevention communities have disagreed with his willingness to vigorously pursue some strategies that lack strong evidence. This was discussed in a blog posting a few months ago by Bob Wachter. Now there's a new issue emerging. Sen. Chuck Grassley has requested that Berwick disclose the funding of the non-profit he founded, the Institute for Healthcare Improvement. According to IHI's 2008 form 990, which can be viewed at the Guidestar website, Berwick's reportable compensation was $2.3 million in 2008. Regardless of the motivation behind Grassley's information request, whether Berwick has conflicts of interest is a legitimate question.

Addendum (8/1/10, 9:50 AM):  Click here for more.

Bundle up!

The New York Times is confirming that Don Berwick, president of IHI, is going to be named the new director of the Centers for Medicare and Medicaid Services. I recommend this thoughtful post by Dr. Bob Wachter on the appointment. As Bob points out, Don is very much on the "just do it" side of the equation regarding infection prevention and other patient safety issues, and his fame has arisen in large part from his amazing charismatic appeal. How this will translate into infection prevention policies at CMS is anyone's guess.