No slam-dunk for Ber­wick ...

CMS con­fir­ma­tion likely to get GOP re­sis­tance

Modern Healthcare - - The Week In Healthcare - Matthew DoBias

A long­time health­care-qual­ity ad­vo­cate could get lost in the po­lit­i­cal tur­moil on Capi­tol Hill as fall­out from the hy­per­par­ti­san re­form de­bate con­tin­ues. Physi­cian Don­ald Ber­wick, 63, a founder of the In­sti­tute for Health­care Im­prove­ment (See re­lated story, this page), re­port­edly has landed as the White House’s choice to run the Medi­care and Med­i­caid pro­grams. Un­der the new re­form law, the CMS will in­flu­ence ev­ery­thing from over­haul of the in­sur­ance sec­tor to the over­sight of new provider pay­ment for­mu­las and the prac­tices that sup­port it.

But with the mem­ory of the al­most yearand-a-half-long fight be­tween Democrats and Repub­li­cans lin­ger­ing, sev­eral sources said, the Ber­wick nom­i­na­tion—once of­fi­cial—will face tough sled­ding. The nom­i­na­tion would have to clear the con­ser­va­tive­lean­ing Se­nate Fi­nance Com­mit­tee be­fore a vote by the full Se­nate.

A se­nior Repub­li­can Se­nate aide, speak­ing on con­di­tion of anonymity, pre­dicted “a se­ri­ous set of hear­ings,” and added, “It’s go­ing to be a chal­lenge.”

Ber­wick, through a spokes- woman, de­clined to com­ment.

The se­nior Repub­li­can on the com­mit­tee, Sen. Chuck Grass­ley of Iowa, has al­ready hinted about the tough task ahead.

“This is al­ways a big job, but the ad­min­is­tra­tion of health­care re­form, which in­cludes im­ple­ment­ing the hun­dreds of bil­lions of dol­lars in Medi­care cuts and the big­gest ex­pan­sion of Med­i­caid in its his­tory, will make it more chal­leng­ing than ever,” Grass­ley said in a writ­ten state­ment. “The Fi­nance Com­mit­tee vet­ting will need to ex­plore the nom­i­nee’s pre­pared­ness for the enor­mous chal­lenges that face the agency.”

It re­mains un­clear when the nom­i­na­tion will be made of­fi­cial. Ber­wick’s name had come up in dis­cus­sions be­fore, dat­ing back to last year, but it be­came clear that the White House did not plan to an­nounce a nom­i­nee for the ad­min­is­tra­tor’s post un­til af­ter the health re­form bills cleared the House and Se­nate.

The last con­firmed CMS ad­min­is­tra­tor was Mark McClel­lan, who held the post from 2004 through 2006 in the Bush ad­min­is­tra­tion, im­ple­ment­ing many of the changes born from

Ber­wick is re­port­edly Obama’s choice for CMS ad­min­is­tra­tor.

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