Berwick's First Reimbursement Challenge

The groups claim that CMS used a flawed methodology to determine the coding change, and the AHA included supporting evidence from two new studies. An analysis by the Moran Company argues that CMS didn’t adequately isolate documentation and coding issues from other factors when calculating the case mix index, and a report from an economics professor takes issue with CMS’ claim that the severity of case mix has been on the decline.

To really drive the message home, hospital trade groups have even been buying television ads implying that the cut will ultimately hurt patient care.

So how will Berwick react to the growing chorus calling for the cuts to be delayed?

Don’t count on him giving in. Here’s Berwick talking about making healthcare more efficient nearly five years ago: “You’re going to run into stakeholders who are going to tell you that you’re harming care, and the knee-jerk reactions of doctors and others will be to reinforce that idea.”

Will Berwick the CMS Administrator have the same attitude and resolve as Berwick the IHI President, now that he’s in the political hot seat and responsible for all the unintended consequences of major change?

We’ll soon find out.