Tavenner Resigns as CMS Chief


January 16, 2015

UPDATED January 16, 2015 // Marilyn Tavenner, the administrator of the Centers for Medicare & Medicaid Services (CMS) and a key figure in the rollout of the Affordable Care Act (ACA), announced today that she will leave that post at the end of February.

Tavenner shared the news with CMS staff this morning in an email. She did not give a reason for her resignation. In addition to "sadness and mixed emotions," she wrote, "I have great pride and joy knowing all that we have accomplished together since I came on board."

A former hospital executive and a registered nurse by training, Tavenner became acting administrator of CMS in November 2011 after the resignation of the controversial Donald Berwick, MD, a recess appointee. Senate Republicans had blocked Dr Berwick's confirmation because of his admiration of the National Health Service in the United Kingdom and alleged support, denied by Dr Berwick, of healthcare rationing.

Tavenner was anything but polarizing when the Senate confirmed her as a full-fledged CMS boss in a 91 to 7 vote in May 2013. Republicans as well as Democrats predicted she would be an able leader of the sprawling agency charged with implementing much of the ACA, including the transformation of Medicare reimbursement from fee-for-service to pay-for-performance.

One of her jobs was helping launch the health insurance marketplaces, or exchanges, through which individuals and families could purchase subsidized plans under the ACA last year. Healthcare.gov, the government website that served the exchanges in most states, worked horribly at first, making it hard to sign up for coverage, but after some fixes, enrollment eventually hit the targets set by the Obama administration.

"It's a measure of her tenacity and dedication that after the tough initial rollout of Healthcare.gov, she helped right the ship, bringing aboard a systems integrator and overseeing an overhaul of the website," said Sylvia Burwell, secretary of the Department of Health and Human Services, in a statement about Tavenner's resignation. Burwell thanked Tavenner for her "exemplary service, leadership and historic record of accomplishment."

Although CMS manages Healthcare.gov, one healthcare industry lobbyist who requested anonymity told Medscape Medical News that the blame for its flawed debut was largely directed at Tavenner's superiors at the Department of Health and Human Services and the White House. "There were no major glitches apart from the rollout," the lobbyist said about ACA implementation in general. "That speaks well of her."

The lobbyist said he did not know of any reason why Tavenner tendered her resignation other than possibly to leave an exhausting job. "Generally people seemed to like her management of the agency," he said, adding that Tavenner appeared comfortable working with Congressional Republicans, who are now in charge of the Senate as well as the House.

One of those Republicans is Sen. Orrin Hatch (R-UT), the chair of the Senate Finance Committee, which has jurisdiction over CMS. In a statement released today, Hatch spoke highly of Tavenner's tenure at CMS.

"Marilyn has done a great job in a very difficult position under near impossible circumstances," said Hatch. "She has proven herself to be a strong leader and a straight-shooter who brought in much needed private sector sensibility into the agency. I truly appreciate her service and wish her the very best in her next adventure."

Not every Republican member of Congress bid her a fond farewell, however. "Tavenner had to go," said Rep. Darrell Issa (R-CA) in a news release. The chair of the House Committee on Oversight and Government Reform, Issa accused her agency of having "deceptively padded" ACA enrollment figures to "scam the American people." Likewise, Rep. Tim Murphy (R-PA), who chairs the oversight and investigations subcommittee of the House Energy and Commerce Committee, issued a statement to Medscape Medical News that chided Tavenner for asking a CMS staffer to delete an email from October 2013 concerning problems with Healthcare.gov.

In the private sector, Tavenner forged a career at the private hospital chain HCA, eventually becoming its group president of outpatient services. She also headed the Virginia Department of Health and Human Resources under former Virginia Governor Tim Kaine. She briefly served as acting CMS administrator in 2010 before Dr Berwick took over.

Andy Slavitt, now the agency's principal deputy administrator, will step in as acting CMS administrator once Tavenner leaves. Before he joined CMS, Slavitt was group executive vice president at Optum, a division of insurance giant UnitedHealth Group with health services ranging from pharmacy benefit management to insuree wellness programs.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: