If Donald Berwick, MD, is confirmed as administrator of the Centers for Medicare and Medicaid Services, he and David Blumenthal, MD, the national coordinator for health IT, would be a "dream team" in pursuing a coherent national healthcare and health IT strategy.

At least that's the assessment of Kerry Weems, who spent 25 years in senior roles at the Health and Human Services Department and was acting administrator of CMS from Sept. 2007 until the Obama administration took over.

"I think that's exactly the kind of team you need to drive results with health IT and not just drive the money out the door," said Weems, now senior vice president for health strategy at Vangent, a provider of information and business process services.

Berwick is a strong proponent of evidence-based medicine, while Blumenthal is leading the campaign to direct the use of health IT in ways that would yield scientifically relevant data on healthcare treatment and practices.
The White House confirmed on Wednesday that President Obama would nominate Berwick, a Harvard health policy professor and a pediatrician, to take the reins of CMS. Berwick is also president and CEO of the Institute for Healthcare Improvement, a not-for-profit organization that strives to improve healthcare quality worldwide.

If confirmed by the Senate, Berwick will become CMS' first permanent administrator since 2006. Charlene Frizzera has been acting administrator since January.

History of public advocacy

Berwick has a long history of research, public advocacy of patient safety, science and evidence-based medicine, Weems said.

CMS has a critical role in carrying out the health reform law. Medicaid, the agency's program for low-income households, will expand health coverage for millions more Americans in 2014. The agency must also phase in billions of dollars in cuts to Medicare, the insurance program for seniors, without diminishing the program over the next 10 years.

More immediately, CMS will direct about $25 billion in payment incentives to qualified physicians and hospitals that become meaningful users of electronic health records starting in 2011 as called for by the stimulus law.

The expected Berwick nomination may follow the logic that led to the choice of Mark McClellan, MD, a physician and academic and the most recent permanent CMS administrator, Weems said.

McClellan was nominated following the passage of "fairly sweeping" Medicare modernization legislation and held that position from 2004 until 2006, Weems noted.
 
When leading a large organization like CMS, the administrator or the deputy administrator has to have strong executive skills, Weems said. In addition to being an academic and physician, Berwick has experience as an executive leading a healthcare improvement organization.

Marilyn Tavenner, the CMS principal deputy administrator, also has strong management and executive skills, he said. She was previously Virginia's health secretary.

If confirmed, Berwick faces an extremely challenging first couple of years, Weems said. "That's a very big job in normal times. And these are extraordinary times."