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Health insurance exchange tech winners and losers

Brian Eastwood | April 21, 2014
Between the federal Healthcare.gov site and various state websites, more than 7.5 million Americans signed up for 2014 healthcare coverage on a health insurance exchange. Building those exchanges proved to be much, much easier said than done. Here's a quick look at who succeeded and who failed.

Losers: Oregon, Oracle

Speaking of what you shouldn't do, let's talk about Cover Oregon. In the long run, this may be more embarrassing than Healthcare.gov.

As of mid-March 2014, the site still wasn't working - and that was one full year after Cover Oregon staff were "shocked" to see that the Oregon Health Authority hadn't yet built a working site.

It gets better (or worse). That quote comes from a tort claim notice - the typical precursor to a lawsuit - filed by Carolyn Lawson, former OHA CIO. Lawson says she was forced to resign amid a "substantial cover-up" about the state of the project and was "privately threatened and publicly scapegoated" when she said she wanted to be truthful with the public. (The Cover Oregon CIO resigned, too.)

Lawson blames Cover Oregon, involved in the project since June 2012, for an "inability to articulate clear business requirements" and "provide effective leadership." She also blames Oracle, saying the firm, acting as a systems integrator, "committed serious and fatal blunders in its work."

The federal Centers for Medicare and Medicaid Services tends to agree. In a report, it says Oracle failed to communicate with Oregon officials in a timely manner, to provide testing results and to plan for disaster recovery and business continuity.

That said, CMS also blames Oregon for never actually setting up a central project management office and relying on the vendor for that purpose. CMS adds that Oregon is using "the most complex mix" of Oracle products among those states working with the vendor.

Losers: Massachusetts, CGI

You'd think the state that successfully build a health insurance exchange website eight years ago would have a leg up on everyone else, right? You're forgetting that the Bay State is the home of the Big Dig, which serves as a proud model of how not to proceed with a highway project.

Why build a new site and not reuse the existing, functioning Massachusetts Health Connector? State officials say they needed to connect to the so-called " Obamacare Hub" that combs IRS, Social Security, Veterans Affairs and Homeland Security data to verify the eligibility of would-be applicants. That part of the site did work - but an analysis from Mitre, a consultancy, found a host of other problems, from inadequate testing to complex governance to faulty architecture.

Massachusetts also played the blame game, pointing to CGI, the contractor also responsible for Healthcare.gov. Testifying before the U.S. House Oversight and Government Reform Committee, Health Connector Director Jean Yang says CGI "impeded our progress and full vision for the website," according to The Boston Globe."

Winner: Kentucky

 

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