What Erik Swensson remembers most about working with incoming Medicare head Marilyn Tavenner is when they brought a woman back from the dead.
It was the middle of the night at Chippenham Hospital in Richmond, where Tavenner worked as an intensive care unit nurse in the 1980s. Swensson, the on-call surgeon, got notice around 2 a.m.: A woman had arrived, after suffering massive blood loss, and was pronounced dead.
Marilyn Tavenner is the nominee to head the Center for Medicare and Medicaid Services.
“That’s about as tough of a case as you get, a girl who was thought to be dead,” Swensson recalled. “Marilyn was very supportive in everything, asking what we were doing, whether I was going to take her back to surgery. We came up with a game plan, and it was right on target. We used about 60 units of blood, but [the patient] ultimately walked out of the hospital.”
Swensson and Tavenner worked together for 13 years in Virginia hospitals. As she rose from ICU nurse to top hospital executive, he saw plenty of the pragmatism and quick thinking that he had seen in the emergency room. “If there was a problem, Marilyn would take care of it,” said Swensson, who is now chief medical officer with the hospital chain Capella Healthcare.
On Wednesday, the White House nominated Tavenner to run the Center for Medicare and Medicaid Services. The announcement was made at nearly the same time that the center’s current head, Donald M. Berwick, submitted his resignation. Republican senators had pledged to block Berwick’s confirmation, and his recess appointment was to expire at the end of the year.
Tavenner joined the Obama administration in February 2010 as Medicare’s principle deputy administrator. In health policy circles, her nomination to head the agency was widely expected.
It is unclear what reception she will get in confirmation hearings. Republicans have reacted cautiously to her nomination. “This is a name that should be sent up to the Senate,” Sen. John Barrasso (R-Wyo.), a vocal Berwick critic, said in an interview. “She should appear and answer our questions on her views on Medicare, Medicaid and the president’s health-care law. Then people can make a reasoned judgment.”
Tavenner has been a relatively quiet presence in the agency, never testifying before Congress.
She and Berwick have taken markedly different paths to the same job. Berwick, a pediatrician who taught at Harvard’s schools of medicine and public health, spent decades writing, thinking and speaking about overhauling America’s health-care system. His sweeping policy ideas were celebrated by many but also became a major political liability. In blocking his confirmation, Republicans seized onto Berwick’s comments about the British National Health Service as a possible “example” for other countries to follow.
Such a situation is unlikely to play out with Tavenner, whose health-care experience lies much more in management than policy. In interviews in the past week, former colleagues described 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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