HIMSS Insight – Dr. Donald Berwick’s Testimony

HIMSS was closely monitoring the Congressional testimony by Dr. Donald Berwick before the Senate Finance Committee on Nov. 17. The subject was Strengthening Medicare and Medicaid: Taking Steps to Modernize America’s Health Care System.

However, this hearing was highly significant because it was the first time Dr. Berwick has testified before the Congress since his nomination as CMS Administrator in April 2010. He was appointed by the President under the recess appointment procedures without Congressional hearings or Senate confirmation.

Highlights of Dr. Berwick testimony included:

100 million Americans now depend on Medicare, Medicaid and CHIP for their healthcare;
He strongly supports the Affordable Care Act (ACA);
The American people are already benefiting from the ACA;
ACA will result in safer care, free from unnecessary medical injuries, errors and infections;
CMS has recently reorganized and is in good position to successfully implement the ACA;
Healthcare costs are not only an issue to the nation but are a big barrier to access to care;
ACA has increased benefits to two million additional Americans;
ACA will result in:
1. Better standards of care and reporting
2. Better quality
3. Improved innovation
4. Berwick’s priorities while CMS Administrator will be:
  1. Better patient care – coordinated care
  2. Better health for the population
  3. Lower healthcare costs
  4. Protect beneficiaries
  5. Make CMS a better agency
  6. Improve prevention – chronic diseases, obesity, prenatal care, etc; and

10. ACA will help the states continue to improve Medicaid and enhance innovation.

Minority members criticized Berwick’s recess appointment by the President without hearings or Senate confirmation, and the fact that after seven months in office, this was the first time he has testified on the Hill. Minority members were adamant that Berwick would be back testifying before the Congress and that CMS would receive rigorous oversight from the Congress going forward, especially on how ACA was implemented and what its costs were.

Some members questioned the SGR and the Medicare reimbursement rates (the doc fix). The current rate structure will expire Nov. 30, 2010, and the rates will be reduced by 23%. The committee chairman was adamant that the situation would be rectified before the deadline.

Berwick’s testimony indicated that the ACA would save money and help extend the solvency of the Medicare Trust Fund. Minority members citing CBO and other authoritative sources questioned the validity of these conclusions. Under ACA, the federal government will be paying 95-100% of the costs for expansion of Medicaid.

Neither Berwick nor the committee members mentioned of HIT or its funding under the ACA.

A videocast of the hearing, along with copies of Dr. Berwick’s testimony and opening statements from Chairman Baucus and Ranking Member Grassley (R-IA), are available on the Senate Finance Committee website.

Contact: Rich Hodge, HIMSS Senior Director, Congressional Affairs, 703-562-8847, Arlington, VA