Sensitive to charges that the rollout of was grossly mismanaged, President Obama's nomination of Sylvia Mathews Burwell to replace Kathleen Sebelius as Secretary of Health and Human Services is an attempt to bolster the department's image with solid management credentials. Currently serving as director of the Office of Management and Budget, Burwell brings a wealth of managerial experience to HHS that the administration hopes will alleviate widespread criticism of Seblius's handling of the botched rollout of President Obama's signature healthcare law.  

"Each party will now gyrate and flip around the House and Senate floor arguing pro and con for Ms. Burwell’s confirmation, but the Sebelius blame card is no longer in the deck for evidence on either side to argue for the repeal or advancement of the Affordable Care Act," says Patrick Riley, connected health senior industry analyst for research firm Frost & Sullivan.

Much work remains at HHS to implement the Affordable Care Act, including another enrollment period about six months from now. In an April 11 ceremony in the White House rose garden with both Burwell and outgoing HHS Secretary Sebelius at his side, President Obama said he "could choose no manager as experienced, as competent" as his nominee. "A Harvard and Oxford educated fiscal whiz kid" is how Riley describes Burwell.  At Oxford University, she was a Rhodes Scholar.

Besides the top job at OMB, which she has held for almost a year, Burwell, 48, has served as deputy White House chief of staff during the Clinton administration and as chief of staff to the Secretary of the Treasury and staff director of the National Economic Council. She also served previously at OMB as deputy director. In the intervening years, Burwell worked as president of the Global Development Program at the Bill and Melinda Gates Foundation, as well as the first chief operating officer, and as president of the Walmart Foundation.

Obama credited Burwell at OMB with her handling of the government shutdown last October, describing her as a "rock--a steady hand on the wheel who helped navigate the country through a very challenging time" and was instrumental in negotiating the two-year budget agreement that put an end to the crisis.

"We don't know her well. We've actually spent some time with OMB over the last year really getting an understanding of what their thoughts and ideas are as they do budgetary analysis of all this legislation," says Russ Branzell, CEO of the College of Healthcare Information Management Executives. "So, we were very fortunate to have spent some time with them but not with her in particular. She's kind of an unknown in our industry but that also might bring a breath of fresh air as far as being able to review and drive things in a new way."

President Obama said that he hopes the Senate will confirm Burwell without delay, noting that she was confirmed unanimously for the OMB position in April 2013. "I’m assuming not that much has changed since that time," Obama added.  

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