AAFP Joins Other Groups in Calling for Senate Approval of Berwick Nomination to Head CMS

The AAFP has reaffirmed its support for Donald Berwick, M.D., as the new administrator of CMS by signing two widely circulated letters calling on the Senate to rapidly approve Berwick's nomination.

President Obama nominated Berwick for CMS administrator in April, and the AAFP quickly endorsed the nomination, saying in a prepared statement that Berwick has "demonstrated a long-standing commitment to building a patient-centered, quality-focused and efficient health care system."

In recent weeks, the AAFP has furthered its endorsement by signing on to two letters sent to Senate leaders in support of Berwick. The endorsements are being conveyed to the Senate now because the Senate Finance Committee is preparing to hold hearings on the Berwick nomination ahead of a vote by the full Senate.

The first letter is being circulated by First Focus, a bipartisan family and children's advocacy organization. It cites Berwick's long history as a pediatrician who has worked to advance health care access and coverage for the nation's children. It also points to Berwick's decades of experience in academia and his work as a research professional, clinician and policy adviser, which makes him "an ideal candidate to lead CMS," according to the First Focus letter, which also was signed by 76 other organizations.

The Patient-Centered Primary Care Collaborative, or PCPCC, is circulating the second letter (1-page Word file; About Downloading). The letter notes that Berwick's career has demonstrated a "drive to provide patient-centered care, patient safety, quality improvement and care coordination in health care."

"He is well respected in the health care community and known for his desire to bring constructive change to health care delivery," says the letter. The AAFP is a founding member of the PCPCC, which now has more than 700 stakeholders on the front lines of health care delivery.

Berwick is a Harvard University professor and the president and CEO of the Institute for Healthcare Improvement, or IHI, a nonprofit organization in Cambridge, Mass., that advances concepts to improve patient care. He is a strong believer that physicians and hospitals can improve care while reducing medical errors and saving money.

As CMS administrator, Berwick would serve as a key player in overhauling the nation's health care system by overseeing a variety of major tasks associated with the new health care reform law. Those tasks include expanding Medicaid coverage, writing new rules and regulations, and establishing pilot projects to test different models of care and payment policies.

However, Obama's choice of Berwick to lead CMS has reignited facets of the health care reform debate. Some Senate Republicans have accused Berwick of supporting health care rationing, and they have criticized Berwick's praise for Britain's National Health Service, a single-payer system that is anathema to many lawmakers on Capitol Hill.

According to AAFP EVP Douglas Henley, M.D., however, Berwick's past comments have been "taken out of context."

"I think the (comments) you see in the newspaper are meant to raise controversy -- those are taken out of context," said Henley in an interview with AAFP News Now. "I am not aware of any of his particular comments that are of concern to the Academy at this point in time."

Henley praised Berwick's "innovative thinking and his focus on improved patient outcomes and patient safety." He predicted that Berwick would be confirmed by the Senate, especially as lawmakers "look at the totality of his work over time."

"The more rational votes and voices will prevail," said Henley. "And that is not just coming from the AAFP but also from the voices of many organizations and individuals out there -- from a very diverse community."

The AAFP has a longstanding relationship with Berwick through the Academy's advocacy efforts in the public and private sectors and through its work and involvement with the IHI.

"We feel we know him well and can, thus, support him for this nomination and confirmation process," said Henley.

Henley stressed that Berwick is "not one to accept the status quo."

"He is one who will want to innovate to improve the system for all concerned, especially improved outcomes for patients," said Henley. This goal entails payment reform to better recognize and reward the provision of primary care services, one of the keys to improving patient care and outcomes, Henley added.

"Primary care and family medicine are essential to a better and improved health care system for patients, both in terms of quality and cost," he said. "So there is significant congruency between how Dr. Berwick approaches the need to change the system and not accept the status quo (and) our views of believing that change -- in order to be successful -- has to be inclusive of further attention and value placed on primary care and family medicine."