Marilyn Tavenner is taking over as Administrator of the Centers for Medicare and Medicaid Services (CMS) after 42 Republicans in the U.S. Senate blocked the permanent appointment of President Barack Obama’s choice, Donald Berwick, M.D.
Tavenner Nominated to Head CMS
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The Associated Press (AP) reported on November 29 that agency observers are expecting a change of style, but not of substance. Her appointment got unexpected support from Republican House Majority Leader Eric Cantor of Virginia. Cantor said Tavenner was “eminently qualified” according to the AP report. He doesn’t get a vote because the Senate approves the appointment, but his support may help her with republican senators.
The White House announced her nomination November 23 and she took over the agency on December 2.
Former HCA CEO
Tavenner, 60, served as Medicare’s principal deputy administrator under Berwick. The AP reported that she started her career as a nurse at two Hospital Corporation of America (HCA) facilities in Virginia. She eventually rose to chief nursing officer and then hospital chief executive in 1993. She then entered government service as Virginia’s health care secretary. She came to Washington last year as Congress was debating the health care reform law.
The Association of American Physicians and Surgeons (AAPS), a group of private physicians, released a statement on November 30, declaring that the “new CMS pick [is] no better than Berwick.” AAPS also pointed to Tavenner’s 25-year career at HCA, which allegedly defrauded Medicare and Medicaid resulting in $840 million in fines in 2000 and another $640 million in 2003. The head of HCA at the time was Rick Scott, who is now the Republican governor of Florida.
The Washington Post reported that former colleagues describe her as a patient-centered manager, a hands-on medical professional equally comfortable in the board room and the emergency room. And in contrast to Berwick, Tavenner isn’t associated with a grand vision for health reform or a particular policy agenda for Medicare and Medicaid.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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