Bad News, Good News: Berwick, a Casualty of Politics, Succeeded at CMS Helm by a Nurse

By Shawn Kennedy, MA, RN, editor-in-chief

Marilyn Tavenner

When Donald Berwick steps down from his post as administrator of the Centers for Medicare and Medicaid Services (CMS) on December 2, he’ll turn the reins over to Marilyn Tavenner, MHA, BSN, RN. Tavenner is not a new face at CMS—she served as acting administrator prior to Berwick’s July 2010 appointment by President Obama and has been principal deputy administrator at CMS since February 2010.

As noted by an article in The Washington Post, Berwick is stepping down in the face of organized opposition to his nomination by Republicans in Congress, who have vowed to block the confirmation he’d need to continue after his recess appointment expires on December 31.

On November 23, President Obama announced his intent to nominate Tavenner for the top post. In her e-mail to CMS staff (carried on the Kaiser Health News site), Kathy Sebelius, secretary of  Health and Human Resources, says of Tavenner, “Her career as a nurse, hospital administrator, and Virginia Secretary of Health and Human Resources give her unique insights that position her well to serve as Administrator.”

I certainly hope so. Berwick’s reputation and track record for pinpointing problems in our health system—and more importantly, working to do something about them through the Institute for Healthcare Improvement—was stellar, and he carried this zeal into his government position as he grappled with the daunting task of implementing reforms in the Affordable Care Act.

Who knows what health care might have looked like after a full term with him at the helm? His departure reminds me of that of another health official who left after one term: Surgeon General Richard Carmona. In an interview with AJN, Carmona told me he thought his greatest success was just surviving his term. The most challenging aspect of the job, he said, “was how politically astute you have to be.”

Tavenner is no neophyte—20+ plus years in nursing, hospital CEO, hospital system executive, and president of Virginia Hospital Association before heading to government service. But then, neither was Carmona or Berwick. No doubt she’ll be carefully scrutinized, as any highly placed appointee should be. If she passes Senate confirmation, she’ll be the second nurse to achieve such a high government post (Mary Wakefield is the director of the Health Resources and Services Administration, HRSA). Nice, but that’s only two. Who’s next?

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2016-11-21T13:11:20+00:00 November 30th, 2011|Nursing|2 Comments
Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.


  1. Lois Roelofs December 1, 2011 at 9:37 am

    When I read this in the paper, as an “old diploma grad” who later earned a PhD, I was proud of how far we’ve finally come. But, yes, who is next? And how many of us will eventually get to this level of health care policy involvement? It’s exciting to think of possibilities. When, not if, they happen, I hope to still be alive to experience them!

  2. Dr. Darrell Spurlock (@darrellspurlock) November 30, 2011 at 4:05 pm

    It’s good to see representation at the highest levels from among the most numerous of America’s healthcare professionals!

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