Centers for Medicare and Medicaid Services (CMS) had a pressing need for change in staffing to meet the requirements. This increase constituted 10% of the existing workforce and twice the agency’s normal annual hiring. Such changes involved not only consideration of new lines of business but also new skills and competencies to effectively rollout provisions made by legislation. Managers were very vocal about their dissatisfaction with both the length of time it took to hire and the quality of applicants that emerged through the certification process. Moreover, like the rest of government, CMS has an aging workforce and will likely face significant retirements in coming years. It must attract and retain a highly skilled workforce to address the increasing pressures of America’s aging population.