"I Look Forward to Transforming Our Health Care System Together"

Jul 19, 2011, 12:00 PM, Posted by

Patrick H. Conway, M.D., M.Sc., is an alumnus of the Robert Wood Johnson (RWJ) Foundation Clinical Scholars program (2005 – 2007) and the new Chief Medical Officer for the Centers for Medicare & Medicaid Services.


I am writing to update the RWJ Clinical Scholars “Family,” the Foundation community and friends, on a new career development. For those whom I haven’t met, I was a RWJ Clinical Scholar at the University of Pennsylvania. I recently took on the role of Chief Medical Officer for the Centers for Medicare & Medicaid Services (CMS) and Director of the Office of Clinical Standards and Quality (OCSQ) for CMS. I report directly to Dr. Don Berwick, the Administrator, and have already learned a lot from him.

The Chief Medical Officer (CMO) portion of this role entails being the senior clinical advisor to the Administrator of CMS, representing the agency to a wide range of stakeholders, and shaping policy across the agency. I work closely with regional CMS CMOs across the country.

The Director of OCSQ role entails leading an office of hundreds of staff, thousands of contractors, and a budget exceeding $1.3 billion annually. Our office is responsible for all quality measures for CMS, including how the measures link to payment. We are responsible for programs such as value-based purchasing for hospitals and other providers, the hospital inpatient quality reporting program, and physician quality reporting system. We are working to align measures across programs, focus on outcomes when possible, improve patient safety, and incentivize coordinated care across settings. We lead quality improvement organizations (QIOs) in all 50 states and three territories and we plan to further develop these organizations into learning networks supporting improvement directly at the front lines of care.

The office is also responsible for all coverage decisions for CMS, including provider services, medical devices and biologics, and diagnostic testing. We believe these coverage decisions can better support quality of care and evidence development.

We are also responsible for all clinical standards, such as conditions of participation, for CMS. We are currently rewriting the hospital conditions of participation, which would be the first time that these have been updated in decades. These conditions guide the survey and certification work done across the country by Joint Commission and CMS surveyors.

Finally, the office contains the information systems group that supports collection of quality measurement data from hospitals, physicians, and other providers across the country.

It was a difficult decision for me and my family to leave Cincinnati Children’s. I was an Associate Professor, Director of Hospital Medicine, and AVP for Outcomes Performance for a health system that is at the forefront of quality improvement and delivering evidence-based care in a highly reliable manner. In the end, the opportunity to serve and improve the health care system at a national level was too great to pass up. I am now a voluntary Associate Professor at Cincinnati Children’s. I am also a voluntary hospital medicine attending at Children’s National Medical Center in Washington, DC on weekends. I still love patient care and believe the experience keeps me grounded in how our policy decisions may play out for those delivering clinical care.

I led a process for our office, OCSQ, to write a vision and mission statement. For the first time, it focuses us on improving outcomes, patient experience of care, and population health and reducing health care costs through improvement. To do this effectively, we will need the help and support of many, including the RWJ family. I have two former RWJ clinical scholars working with me in OCSQ but we could certainly use more. I also hope to call on many of you outside of government to inform our work and to guide me through some difficult decisions.

In my first two months, the potential breadth and depth of impact of so many of our decisions on the health care system has been astounding. I am working hard to make decisions that optimize health outcomes but recognize that listening to patients, providers, and health care experts, like RWJ scholars, is essential. I am serving as a senior non-political government employee so I hope to be able to contribute, with your help, for years to come. I look forward to us transforming our health care system together.

Read about Conway’s previous work here and here.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.