Remarks by Andy Slavitt to the CMS staff: A simple thank you

Below are prepared remarks by Andy Slavitt, CMS Acting Administrator before a CMS All-Staff Meeting on January 17, 2017

Good afternoon and welcome.

I remember about 2 years ago coming here for the first time, sitting down with Aaron Albright at our first all-staff chat. My thoughts today come full circle to my goals and aspirations for CMS and for you — from where we started to where we are now. But, I want to start by talking about how CMS has affected me.

CMS has been my family these last 2 years. I’ve been away from home, living in an apartment, away from my wife and kids. We believed this would allow me to focus on work, without the distraction of home life during the week. What I didn’t see coming was how much CMS would also begin to feel like home. And it began almost instantly as everyone generously welcomed me in as if I had been here forever. I will never forget how you made me feel part of the team.

I recognized how much I had to prove in joining this family. You had all dedicated a great deal of your lives as public servants and I was just beginning. I promised myself that even though I could never match the decades so many of you have contributed here at CMS, my aim would be to try to have the impact of 20 years in the two I had ahead of me by figuring out where I could help the most and then giving it everything I had. I know I didn’t succeed in everything I tried to take on, but the team here at CMS was generous and patient. You welcomed me into your offices when I visited the regions. I asked what could be done to make your work here better and you told me what mattered to you. As I did this, I got to see the impact and vitality of the work up close. I was most impressed with stories of why you have chosen to be here.

You also listened to my opinions when we talked together about what we could become and what we could achieve:

Getting closer to our customers. Executing with passion. Working together in new ways across our silos.  Not being afraid to take on challenges and do our best work. Opening up and exposing ourselves transparently so we could get closer to the action. Closer to where Americans get their care. Listening to all the voices impacted by our work. Measuring ourselves not by our own standards, but by the standards of the outside world. Being self-critical instead of defensive.

You showed me we could do all of these things and I believe that one of the keys to our success has been and will be our culture. The country needs a visible approachable government they can feel confident in, and the health care system needs an approachable and open CMS to partner with them.

I remember standing on this stage two years ago and telling you that these would be the most important and meaningful years of my career. And they have been. I can’t think of a better job and a better place to be of service. I’ve been fortunate to learn from you and work with you. Simply said: my days have been filled with meaning every day at CMS. 

Never forget that for millions of Americans, you are what stands between them and access to better care; to security; and between them and freedom from injuries, sickness, and mental illness. With these patients and consumers in mind, there was nothing, as Acting Administrator, I wouldn’t do, no one I wouldn’t speak up to, no fight I wouldn’t enter.

I hope you felt that the CMS “political leadership team” and I represented CMS well and helped advance the work, all while helping the agency grow with and adapt to the times. I want to pause and thank the political leadership team that will be leaving public service in a few short days. They are an extremely strong group of leaders that have lead with compassion and high integrity. I will be eternally grateful for all that they have done and I’m proud to have worked so closely with each one of them.

It is remarkable, even in my short time here, to step back and think about how much you’ve accomplished. I will read a small subset of what has been accomplished…

• You completed one of the most far reaching implementations in health care– ICD- 10– without a hitch and with wide praise from physicians.

• You began implementing the complex laws in MACRA with class and to accolades.

• You have begun to change how we pay for care, launching, listening and re-launching new approaches to increase quality, improve coordination and teamwork, and reduce unnecessary variation.

• To wide opposition, you fought tooth and nail to enroll people in Marketplace With each bit of adversity, you got better and less likely to lose. Keep this tenacity.

• State-by-state you listened and solved problems so their residents could enjoy access to Medicaid expansion on terms that worked for them and supported principals that mean something to the program. Among many amazing and important things you did to put the principals back into the financing structure of Medicaid, you also made a difference in people’s lives, including a major advance heralded far and wide in the Tribal community.

• You made a commitment to health equity and to vulnerable populations like those people who are dually eligible for Medicare and Medicaid that began with the people and quickly drove into principals and actions.

• You took on tough issues, whether the cost of drugs, disparities among socioeconomic status, measurement, major safety concerns, or fraud. You didn’t back down from protecting people.

• You became the undisputed industry leader in data transparency, driving the industry to improve by providing the tools and listening to their needs.

• You used Medicare payments, quality and programs to accomplish important aims: investments in people with lower socioeconomic status, more investment in primary care and integrated mental health.

• You made a commitment to core operational execution. In responding to Freedom of Information Act requests, case work, appeals, technology, security, contracting or budgeting, and showed measurable progress in these areas.

• Our culture and commitment to one another is sound. Our employee engagement is at peak levels and climbing and we are among the very top across government.

• You demonstrated the power of relationships. Your work on the Hill as a trusted partner; your relationships with the media; the respect you garnered in the White House, with the Secretary, with other agencies, with advocates and partners and so many others represents a stark turnaround in how we are perceived. Frankly, the reputation of CMS feels as strong as ever.

• You invested in the future and peered around corners– whether on fraud prevention, better analysis of Medicare cost trends, prevention models, or cybersecurity. Thanks to our “guardian program” – no major cyber issues have occurred. I won’t be around to ask, but keep it up!

• And what makes me very proud is how you have innovated. Innovation to make sure people are treated with dignity using cool technology. Whether it’s Blue Button, MAGI in the cloud, automated Medicaid enrollment, TMSIS, cms.gov, Fraud prevention 2.0, or Compare site, CMS is a modern tech-enabled customer service organization that delivers the goods.

Not long after the HealthCare.gov challenges, the team started to get a number of successes under our belts. I had the opportunity to tell the White House and the Secretary to give CMS the hard problems, the big challenges, the mission critical projects the health care system is dependent on. And we would deliver. You have.

I am confident you are well positioned for whatever comes next. As strong as CMS is performing, you can do even more.

I had the opportunity to spend time with Seema Verma, the nominee for Administrator of CMS. If confirmed, she is excited to meet and work with the staff and I believe understands the great honor granted to her by the President-elect in appointing her to work at CMS. I told her what she will soon see: you are the strongest workforce in health care and, one could argue, what you deliver is at the highest levels of any government agency.

Welcome her the same way you welcomed me: Listen to the new team’s priorities and teach them yours.

All great organizations have one common trait: They are adaptable. They can take weaknesses and make them strengths. They know how to change with the times. They can absorb new people. Build new units. Find new ways of doing things. CMS has shown itself not to be the rigid organization that characterizes so many organizations—government or private sector. You’re good at what you do, but know how to use it to be nimble and adaptable. This will serve you well.

My ask of you is keep doing these things and more. The President-elect is certainly right on this point — winning feels good. To that I would add “…when your winning helps others.” Rack ‘em and stack ‘em. You keep doing the things we’ve done together—listen to the customer, work as a team, be intentional about your goals.

Let me close with a final note. Yesterday we celebrated Martin Luther King Jr. day. It is a day that always reminds us that for those gains we have made as a country, we need to be vigilant to make sure that no one in this country gets treated as less than an equal. That rights are what we fight for. I know you do that in your work every day.

There are also important rights you as federal employees and as individuals have. At CMS and in our government, no discrimination will ever be tolerated. There can be no intimidation. There will remain equal opportunity for all our people—LGBT, people of color, women, individuals with disabilities. No one can take that away. For those of you that ever have concerns, just speak up. CMS has and will always support you.

On behalf of President Obama, Vice President Biden and Secretary Burwell, I simply say thank you.