WASHINGTON – Pediatrician and Harvard professor Donald Berwick, MD, chief of the Centers for Medicare & Medicaid Services since July 12, went to Capitol Hill Wednesday to outline the agency's plans for making the programs stronger and more modern, in part by employing health information technology.

Republican members of the Senate Committee on Finance took the opportunity to not only question him about the programs, but also to press him on how he was appointed to his job in the first place.

"Why did you decide to accept the recess appointment by President Obama in July?" Sen. Jim Bunning, Republican of Kentucky asked.

Berwick responded it was because the president asked.

"When asked I came, because it was my duty to do that," Berwick said.

But with only five minutes each to question Berwick, there was not enough time to pursue the topic – not even enough time to ask the questions they had, Sen. Orrin Hatch (R-Utah) complained.

"This is pathetic," Hatch said, "We ought to have time to have the most important man in America on healthcare answer questions."

The unanswered questions could be submitted in writing, Committee Chairman Max Baucus (D-Mont) assured him. Berwick told the senators he would meet with any of the senators at any time, as he saw it as part of his job.

President Obama's appointment of Berwick during a Congressional recess was viewed by some members of Congress and others as an end-run, an opportunity to avoid congressional hearings.

'Doing things right'

At the start of his testimony on Wednesday, Berwick told the committee how he viewed his responsibilities as head of the $800 billion-a-year agency with 100 million beneficiaries.

"I'm a physician," he said, "the son of a general practitioner, who practiced in rural Connecticut."

His father practiced without the technological advantages available today. Berwick told the committee he would do his best to take advantage of these advances in service of the patients and to make the Medicare and Medicaid programs operate more effectively.

"Doing things right costs less than doing things wrong," he said.

He would champion integrated, coordinated care, Berwick said, and then "really getting serious about wellness upstream."

Integration would require a solid infrastructure, he knew. He noted that to assist states in the implementation of the Affordable Care Act, CMS has proposed to increase the current 50 percent federal match to a 90 percent federal match for investments that states make through 2015 to streamline and upgrade their Medicaid eligibility systems. CMS has also provided states with guidance on how to establish IT systems to enroll individuals who qualify for Medicaid or CHIP, premium tax credits or cost-sharing reductions in the exchanges available through the Affordable Care Act.

"These efficient technology investments will support a coordinated, consumer-oriented system for individuals, families and businesses to sign up for the health insurance plan that they choose," Berwick said.

"I have devoted my career to the belief that all patients deserve access to high quality health care, regardless of who they are or whether they live in a large city or a small rural community," he added. "High quality healthcare does not necessarily mean the most expensive healthcare. It means safe care, free from medical injuries, errors and infections; it means reliable care, based on the best available science; and it means person-centered care, in which each patient is treated with dignity and respect for his or her own unique preferences.

"These core beliefs will continue to shape my work at the Centers for Medicare & Medicaid Services (CMS)."