New HHS Secretary Reshuffles Obamacare Management

In preparation for this fall’s Affordable Care Act enrollment period, Health and Human Services Secretary Sylvia Burwell on Friday announced a new management structure drawing on recommendations following last year’s messy rollout of Healthcare.gov.

The Centers for Medicare and Medicaid Services will gain a new operations-focused principal deputy administrator for agencywide policy and operational program coordination, a position to be filled by private sector technology executive Andy Slavitt, formerly of Optum. In addition, a marketplace CEO and a marketplace chief technology officer will soon be hired to focus on the exchanges in 36 states currently being run by the federal government.

“These actions will bolster our team and further instill ongoing accountability for reaching milestones, measuring results and delivering results for the American people,” Burwell said. “Under this new structure, we bring additional operational and technological fire power and have a clear single point of contact in the marketplace CEO to streamline decision-making.”

Slavitt, who led the late “surge” last winter to repair the balky website, will be responsible for cross-cutting policy and operational coordination for the agency’s Medicare, Medicaid, Children’s Health Insurance program and marketplace initiatives; combatting health care fraud; reforming health care delivery; and improving health outcomes, HHS said. “Andy’s breadth of experience throughout the health care sector makes him the right person for this role, and I am excited for our partnership across all of the CMS programs,” said CMS Administrator Marilyn Tavenner. “He will focus on managing day-to-day operational issues across all of our programs and be a key part of our leadership team.”

The unnamed marketplace CEO will lead the federal marketplace, manage relationships with state marketplaces and run the Center for Consumer Information and Insurance Oversight, which regulates health insurance at the federal level, HHS said.

Reporting to the new CEO will be the marketplace CTO, who will work with the CMS deputy chief operating officer and Office of Information Services “to ensure proper alignment of project milestones and deliverables,” HHS reported.

These CMS personnel actions come at the same time as Kurt DelBene, who has served temporarily as the secretary’s senior adviser on Healthcare.gov, prepares to leave the department as planned at the end of June.

The management shifts came a day after Republican minority members of the Senate Finance Committee issued a scathing report on the website, attributing its shortfalls to a poor information technology plan, even poorer management and leadership that focused more on plausible deniability than performance.

But the moves also followed an in-depth HHS report on the election-year sensitive topic of the affordability of health insurance premiums and competition and choice in the health marketplace. That report showed that with federal tax credits, insurance shoppers in 36 states were now paying an average of $69 per month for the Affordable Care Act’s “silver plans," and could choose, on average from among 47 plans offered by five insurers. “Nearly 7 in 10 consumers who signed up for marketplace coverage are paying $100 or less for that coverage,” Burwell said. “When there is choice and competition, everybody benefits.”