Doing More With Less: A Conversation With Kerry Weems

The Centers for Medicare and Medicaid Services (CMS) is a resource-starved agency with few friends on Capitol Hill. From the perspective of its last administrator, neither Congress nor the White House, regardless of party, provides CMS with the resources to effectively manage its vast responsibilities-particularly when it comes to fighting fraud, which costs taxpayers billions every year. Although its annual expenditures approach $700 billion, CMS has fewer full-time employees today ( about 4,600) than it had a decade ago. With the prospect of health care reform looming, the role that Congress may assign CMS in its weakened state becomes a major policy question. [ Health Affairs 28, no. 4 ( 2009): w688-w696 (published online 18 June 2009; 10.1377/hlthaff.28.4.w688)]