Donald Berwick, President Barack Obama's choice to lead the agency that runs Medicare and Medicaid, will face major challenges in implementing the sweeping changes to both programs required under the recently enacted health care overhaul … if elected.
According to two administration officials, President Obama will nominate Dr. Berwick, a Harvard University professor and specialist in patient safety, to take over the top post at the Centers for Medicare and Medicaid Services. The post has been vacant for more than three years.
Dr. Berwick runs the Boston-based Institute for Healthcare Improvement and is a pediatrics and health-policy professor at Harvard. His focus has been to improve patient safety by applying more systemized procedures to the medical field. He has also worked as an executive at a Massachusetts health-maintenance organization.
If confirmed by the Senate, Dr. Berwick must prepare for a major expansion of the Medicaid federal-state insurance program for the poor starting in 2014, as required by the health-overhaul legislation. The program is expected to add some 16 million Americans by the end of the decade as part of the new law's expansion of insurance coverage. But currently states are cutting funding for the program because their budgets are squeezed, and many doctors have stopped taking Medicaid patients because it reimburses them at a lower rate than private insurance.
For the Medicare insurance program for the elderly, the top challenge will be phasing in more than $400 billion in cuts over the next decade to health-care providers who participate in insurance program for the elderly without weakening it.