He provided the vision, but maybe not the details
A little-discussed aspect of the Berwick era at the CMS was the view of some healthcare provider advocates that the soon-to-depart administrator was not that great at the administrating part of his job. That is, Dr. Donald Berwick was exceptional at developing big-picture, inspirational approaches to overhauling healthcare delivery and payment models, but he was relatively weak at the humdrum task of shepherding rules through the regulatory process.
Such regulatory management has taken on paramount importance since enactment of the Patient Protection and Affordable Care Act last year. Hundreds of thousands of pages of rules are anticipated to fully implement it. The CMS was charged with developing the vast majority of the law’s regulations and many of the rules required to date have missed their statutory deadlines.
Some provider advocates—who asked not to be named—blamed the long-time academic and think-tanker Berwick for such delays, on the grounds that he was not staying abreast of the labyrinthine regulatory development process for each of the often-complex measures.
Such a job description appears to better match the newly nominated CMS administrator, Marilyn Tavenner, who has extensive public and