Changing face of Medicare. As the popular administrator prepares to make his exit, providers shouldn't expect much change in direction by his replacement.

With Mark McClellan poised to exit the CMS, names of possible successors are already being floated in Washington, including CMS executive Herb Kuhn, left. Observers say whoever takes the job will face some tough challenges, and they don't expect much policy to change with Bush still in the White House. "We will continue to see what has effectively been gridlock" on many major healthcare issues, one said.