He pro­vided the vi­sion, but maybe not the de­tails

Modern Healthcare - - OUTLIERS -

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

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