IHI: Berwick on ACOs, Congress, Fraud

Cheryl Clark, December 7, 2011

Five days after leaving his 17-month post as head of the Centers for Medicare & Medicaid Services, Don Berwick, MD, said his most rewarding moments were those in which he attracted the sharpest criticism—during the formation of rules governing accountable care organizations.

"We had a chance to work with the whole country in this thinking about what seamless care ... should look like," Berwick told a small group of journalists Tuesday in Orlando at the annual forum of the Institute for Healthcare Improvement. Berwick co-founded the organization 20 years ago.  

"I think overall it was the best experience of my whole time there...It was just very interesting, with very vivid national dialogue. It was just the way democracy should work."

Even though he took the brunt of criticism, especially when numerous high-profile providers blasted the proposed rule's language for shifting too much risk their way? Even when major healthcare system leaders said they felt he was out of touch?

"It's learning," Berwick replied. "You know, I don't think of it as me being the brunt of criticism. I was the beneficiary of dialogue," he said.

Writing the ACO Rule
"We tried. The staff worked very, very hard. It was very complicated. There were about 30 variables...and we took a good shot. And remember, there were a lot of stakeholders. And out of that process came a much better rule informed by the dialogue."


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