Berwick grilled by Senate Finance Committee
Donald Berwick, MD, administrator of the Centers for Medicare & Medicaid Services, faced the Senate for the first time on Wednesday, a few months after President Barack Obama nominated him to the post in a move designed to avoid such a review.
GOP Senate Finance Committee members were frustrated and angry that they hadn't had the chance to interview and confirm or deny Berwick for the position that ranking member Chuck Grassley (R-Iowa) called "one of the most important jobs in government today."
Berwick, president's point man on Medicare, was ushered into the job through a recess appointment, or a nomination made by Obama while Congress was in recess and therefore unable to interview him. One stipulation of the appointment is that Berwick's time in office will only last through the end of next year,
Committee Chairman Max Baucus (D-Mont.) questioned Berwick sternly and expressed annoyance toward committee members who badgered him for the lack of a nomination hearing earlier.
Wednesday's hearing lasted for one hour – not nearly enough time, according to most committee members.
Baucus promised future hearings to allow for more questioning of Berwick on how he plans to run the $900 billion U.S. healthcare entitlement program serving more than 100 million beneficiaries.
Sen. John Cornyn (R-Texas) bluntly asked the question on most GOP members' minds; Why had Berwick accepted the recess appointment in July without a Senate Finance Hearing approval?
"You had a choice to say no," he said.
"I accepted the job because the president of the United States asked me and I want to serve my country," Berwick replied.
Few are questioning Berwick's healthcare credentials. A practicing pediatrician for 20 years, a former professor at Harvard Medical School and a leader in healthcare quality efforts for the past two decades, he told the committee there has never been a better time for improving the health of Americans. Much of this he attributed to the passage of the Patient Protection and Affordable Care Act.
As for how Berwick promises to prioritize CMS' agenda over the next year, putting an end to medical errors is near the top. Not only is that good for patients, he said, but "doing things right cost less than doing things wrong."
"When we raise the level of care for Medicare beneficiaries, we raise it for all Americans," Berwick said. But doing so, he said, will take a joint private-public effort.
Berwick said he has seen large and small hospitals and physician practices across the country, in both urban and rural areas, that have discovered ways to improve quality of care while cutting costs. "The imagination in this country is extraordinary," he said. "I can see the inventive energies out there."
Berwick said providing rewards and incentives to physicians and hospitals will be key. In addition, accountable care organizations and medical homes will help drive the data-collection on what works in care and will push entire groups of providers to improve together.
