It’s difficult to overstate the significance of CMS’s mission. The agency’s actions affect millions of people, allocate over one trillion dollars and ultimately do much to influence America’s health. When I took on the position of Administrator, I was often advised to choose one or two areas of focus. Don’t take on too much, or you might not get anything done – so the advice went. But I perceived that the problems in American healthcare call for sweeping, not incremental, change.