Robert Berenson, M.D., is an Institute Fellow at the Urban Institute. He is an expert in health care policy, particularly Medicare, with experience practicing medicine, serving in senior positions in two Administrations, and helping organize and manage a successful preferred provider organization. From 1998-2000, he was in charge of Medicare payment policy and private health plan contracting in the Centers for Medicare and Medicaid Services. Previously, he served as an Assistant Director of the Carter White House Domestic Policy Staff and recently was a member of the Obama transition team. Effective July 2009, Dr. Berenson became a Commissioner of the Medicare Payment Advisory Commission (MedPAC). In July 2010, he became vice chair of MedPAC.


Dr. Berenson is a board-certified internist who practiced for twenty years, the last twelve in a Washington, D.C. group practice, and is Fellow of the American College of Physicians. He helped organize and manage a successful preferred provider organization serving the Washington, D.C. metropolitan area. He was co-author, with Walter Zelman, of The Managed Care Blues & How to Cure Them, published in 1998, and, with Rick Mayes, Medicare Payment Policy and the Shaping of U.S. Health Care in 2006. He is a graduate of the Mount Sinai School of Medicine and on the faculty at the George Washington University Schools of Medicine and Public Health and the Fuqua School of Business at Duke.


Recent Posts by Robert Berenson

The AHCA Gets It Wrong: Health Care Is Different

In many ways, the AHCA's reliance on consumers to fend for themselves in buying health care services represents a fundamental rejection of the prevailing policy viewpoint: Kenneth Arrow's argument that the economic problems in health care are related to uncertainty in both disease and in treatment.

Refining The Framework For Payment Reform

Moving from a system that rewards volume over value is a complicated and messy process. No method is ever implemented in isolation---either one at a time or in a vacuum---and many payment methods do not yet have a sufficient track record to help us prioritize among them.

September 19, 2016Costs and Spending, Payment Policy

Understanding How Payment And Benefit Designs Work Together In Health Care

While Medicare and Medicaid benefit design is set by law and effectively frozen, private health care purchasers are able to innovate freely. The Urban Institute and Catalyst for Payment Reform partnered to define and categorize the payment methods and benefit designs available in the market...

How Solid Is The Primary Care Foundation Of The Medical Home?

MACRA identified the PCMH model as a presumptively qualifying Alternative Payment Model that would give physicians higher payments. A recently completed a study examines the interaction of advanced primary care practices and ACOs. This blog derives from the authors' review of the literature on...

New Health Care Symposium: High Prices And Payment Reform—Let’s Get Practical

Addressing provider consolidation and high health care prices will require looking beyond antitrust law. What I prefer to call “legacy payment” methods (most of these payment methods, including DRGs, are not fee-for-service) can be improved substantially to address the medical arms race.

Changing Provider Networks In Marketplace Health Plans: Balancing Affordability And Access To Quality Care

Editor's note: In addition to Sabrina Corlette, JoAnn Volk, Robert Berenson, and Judy Feder coauthored this post.  Twelve percent of the complaints to California’s Department of Managed Health Care this year relate to access to care problems. In New Hampshire, consumers were upset to learn...

Acknowledging The Elephant: Moving Market Power And Prices To The Center Of Health Policy

Editor's note: See Stuart Guterman's post on consolidation and market power in health care, also published today, and watch for more on these subjects in Health Affairs Blog. Health Affairs recently published a set of papers addressing the problem of provider consolidation and consequent...

Good Palliative Care Requires Good Long-Term Care: A Medicare Strategy To Strengthen Both

Editor’s Note: This post is also coauthored by Robert Berenson, an Institute Fellow at the Urban Institute.  This post is the fifth in a periodic Health Affairs Blog series on palliative care, health policy, and health reform. The series features essays adapted from and drawing on an...

Seven Policy Recommendations To Improve Quality Measurement

Performance measurement -- if done right -- can be a core activity to move the health care system to higher value for the American public, while rewarding health professionals and health care institutions for doing the right thing for their patients. Yet, policy makers, private and public, have...

Reforming Medicare’s Governance To Enhance Value-Based Purchasing

With the release of the Medicare Trustees’ report for 2009, the worsening economy, and the continued high and rising cost of health care, many are anxiously awaiting a credible plan to reform the Medicare program and the health system as a whole. As Peter Orszag and others have argued...