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Industry Stakeholders React--Or Not--to Tavenner's Departure

January 16, 2015
by Gabriel Perna
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Some in healthcare are remembering Marilyn Tavenner's time as Administrator for the Centers for Medicare and Medicaid Services (CMS) in a positive light, while hoping for a quick transition under the new leadership. Others are remaining quiet, opting not to release any kind of statement. 
Tavenner, who is leaving the government at the end of the month and will be replaced by Andrew Slavitt, principal deputy administrator for CMS and second in command, came to CMS in 2010. She was quickly thrust in a leadership role and by 2011, was appointed acting administrator of CMS. She was confirmed in the role in 2013 by Congress. 
During her tenure in CMS, the government rolled out the Affordable Care Act's (ACA) Healthcare.Gov website, which had a tumultuous start. For this reason, Tavenner had to testify in front of Congress and explain what had happened to cause a two-month delay. The issues over the website and rollout of the ACA were a continuous thread for Tavenner, since late last year, through this past month when she was questioned by Representative Darrell Issa (R-CA) for false enrollment numbers. 
For those in health IT, Tavenner was champion of regulatory measures like meaningful use and ICD-10. Despite pushback from numerous industry groups, she often aimed to keep those regulatory measures moving forward. She also oversaw progress of various CMS-based ACA initiatives that impact health IT, like the Voluntary Accountable Care Organization (ACOs) programs and the mandatory Readmissions Reduction Program. Under her watch, CMS also entered into an era of data transparency, with the agency releasing hospital charge information over the last few years. 
In response to her departure, some health IT groups are honoring Tavenner for her time at the top of CMS. Russ Branzell, the CEO of the College of Health Information Management Executives (CHIME), told HCI that she led during a time of much disruption. "Anyone can lead during easy times with easy programs, I think credit goes to her and many that have become before and those in similar positions with HHS are willing to lead during the toughest, most disruptive times we've had," Branzell said. 
According to Hospitals and Health Networks, American Hospital Association's CEO, Rich Umbdenstock echoed Branzell's sentiments in a statement: "As both CMS administrator and deputy before that, Marilyn leaves a legacy of having played a major role in making sure that millions of Americans have access to health coverage,” AHA President and CEO Rich Umbdenstock said in a statement.
Branzell said it's imperative, because of the continued flux over meaningful use and HIT adoption, that any transition in a significant role at HHS move quickly. He isn't worried about CMS losing focus though.
"There's some concern with that, but given the timing with the [impending] Stage 3 [proposed rule] release, the discussion being reviewed within that for some flexibility, and more work to be done on usability of tools and overall interoperability, I am not sure how we couldn't continue to keep focus," Branzell said. "A change at the top may create some obstruction, the overall desire from across all of the industry will keep us moving forward." 
A couple of groups decided to remain quiet on Tavenner's departure. Most notably was the American Medical Association (AMA), a group that supported her confirmation to be CMS administration but was later at odds with the administrator over ICD-10, meaningful use, and other regulatory requirements. Most recently, the AMA released a statement in December saying it was "appalled" with CMS over potential penalties for physicians under meaningful use
A couple of politicians, both frequently involved with healthcare legislation showed appreciation for Tavenner. 
Sen. Lamar Alexander, (R-Tenn.), Chair of the Health, Education, Labor, and Pensions Committee and a constant commentator on health IT reform and regulatory activity, had this to say: "I am grateful to Administrator Tavenner for her service—she has always been accessible and willing to listen to questions and concerns. I urge the president to nominate someone to replace Ms. Tavenner who will work with Congress to make the structural reforms necessary so that seniors can count on Medicare to pay their hospital bills—the reforms in Fiscal Sustainability Act, for example,"
Sen. Orrin Hatch (R-Utah), who once asked Tavenner and other health IT government officials to press pause on meaningful use, said this in a statement: "Marilyn has done a great job in a very difficult position under near impossible circumstances," said Sen. Orrin Hatch of Utah. "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."