CMS chief, Don Berwick, has often taken a measured approach to policy implementation. His entire premise on Medicare and Medicaid reform is based upon rational thought and not upon hurried or vaulted extremism. Case in point: Berwick recently criticized President Obama’s support of a Medicare payment advisory board if spending on the entitlement began to outpace the GDP. Recommendations by the board would then go to Congress for approval. HHS would get involved if congressional approval was not secured for any reason. Cuts to Medicaid spending appears to be Obama’s goal here. It is the latest in a long succession of fiscally conservative overtones to overhaul the Budget in response to the much heralded and recently House-passed Ryan bill to trim the deficit and attack what the GOP sees as reckless spending on the part of federal government. As a result of pending Senate passage of the bill with executive approval (unlikely), Medicare would be subject to the most expansive overhaul it’s seen in a while and would employ a privatized system of governance with respect to its funding via vouchers. Rep. Ryan’s bill notwithstanding, Berwick is signaling the tried-and-true approach to controlling CMS dollars: by improving care delivery under Medicare. It may be boring, but it works.
“The best way to make care more affordable and sustainable is to make care better,” he said. “Higher quality and lower cost go together.”
He continues to cite Medicare pilot initiatives in reducing hospital-acquired preventable infections, increased scrutiny of MA programs’ costs, and the use of transparency in the dissemination of quality indicators (he unveiled a new government website which has this information) to spur “invention” in care delivery. Regardless of how one feels about Medicare reform in an absolute sense, it is very interesting to note the media’s coverage of the matter — seemingly eschewing Berwick’s deliberate approach to reform in favor of Paul Ryan’s incendiary one.
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