Exclusive Interview with Marilyn Tavenner (CMS)

Why This Topic Matters

CMS policy affects claim submission, compliance expectations, education needs, payment models, and preventive coverage across the healthcare system. Readers who work with Medicare, coding transitions, or audit readiness can use this interview to understand the agency’s priorities and the general direction of federal reimbursement and oversight efforts.

Article Sections

1. CMS leadership perspective and agency priorities

   The interview opens with background on CMS leadership experience and broad priorities at the agency. It discusses healthcare reform, operational challenges, and major areas of focus under CMS.

2. ICD-10 testing and implementation readiness

   This section addresses CMS testing activities and system readiness related to the ICD-10 transition. It also discusses the agency’s approach to internal validation and external participation.

3. ICD-10 education and stakeholder resources

   CMS describes education efforts for stakeholders involved in the transition to ICD-10. The section highlights available learning resources and training support for different audiences.

4. Program integrity, fraud prevention, and audit oversight

   The discussion shifts to enforcement, improper payments, contractor review activity, and the role of documentation in oversight. It also covers the agency’s broader approach to reviews and standards.

5. Payment reform, accountable care, and delivery models

   This section focuses on alternative payment approaches and care coordination initiatives. It covers CMS efforts involving shared savings, bundled payment concepts, and primary care innovation.

6. ACO impact and beneficiary cost trends

   The interview addresses the expected effect of accountable care arrangements on Medicare beneficiaries. It references early program results and general cost trend comparisons.

7. Preventive services and future Medicare policy

   The final portion discusses preventive care coverage and the role of health maintenance in Medicare policy. It also touches on broader reform efforts affecting beneficiaries and plan design.