Healthcare.gov Rocky Rollout by Galorath.com

Understanding Healthcare.gov's ROCKY ROLLOUT Under The Hood of Healthcare.gov User User User Identity Management 3rd Party Insurers Government Data Hub System 2 Why did healthcare.gov have rollout problems? Extreme number of legacy systems, inside Government and among 3rd parties Citizenship certification Numerous, powerful stakeholders: and income the President, insurance companies, states, Congress verification Complex eligibility rules Not enough time Not just another eCommerce site! START! A volatile environment with numerous starts and stops: Supreme Court, Presidential election, extreme political disagreement Registration requirement added very late in development Different rules for different states 3. How much has been spent on Healthcare.gov? About $150M Source: www.gao.gov/assets/660/655291.pdf page 38 4 How much does $150M buy? Assuming... 10-30 major systems 000000000000 $18K average monthly contractor cost (government rates) 09))))9 Þ)))))9Þ))) About 1.3 Taking just over MILLION HOURS 2 YEARS NOVEMBER 2015 Source: Galorath's SEER-SEM Estimation Model 0100 1011 What kind of quality is delivered on delivery day? MILLION HOURS 2,500 defects at delivery THOUSAND DELIVERED DEFECTS 2 1.5 3 1.0 0.5 -4 MONTHS FROM ESTIMATE -6 -5 -3 -2 -1 3. 4 6. How much software can you buy for $150M? 500,000 to 600,000 lines of code Or about 24,000 unadjusted function points Source: Galorath's SEER-SEM Estimation Model 0100 1011 in other words... QuickBooks Half of Android 4.0 One tenth of Quickbooks (2012) A teeny fraction of Facebook (2011) Sources: thenextweb.com/google/2011/10/19/googles-andy-rubin-there-are-over-1-million-lines-of-code-in-android/#article .drdobbs.com/tools/building-quickbooks-how-intuit-manages-1/240003694 www.wired.com/wiredenterprise/2013/04/facebook-windows/ Why did some states develop their own exchanges? Historical insurance State-specific insurance markets sovereignty within states Sarah Dash, a research fellow at Georgetown's Center on Health Insurance Reforms Source: www.foxbusiness.com/personal-finance/2013/10/16/why-state-run-health-exchanges-are-faring-better/ 8. Which states developed their own exchanges? Default to Federal Exchange Planning for Partnership Exchange Declared State-based Exchange ME WA MT ND MN NH ID WI VR OR SD NY IA MI NE CA NV UT IN OH PA I MA CO мо IL I RI KS wy ICT INJ KY VA DE AZ NM ок AR NC I MD TN IDC MS AL GA SC TX LA AK FL HI Source: www.washingtonpost.com/blogs/wonkblog/wp/2013/02/18/its-official-the-feds-will-run-most-obamacare-exchanges/ What were the states' web site experiences? Amounts Include all ACA rollout costs in each state, generally more than twice the cost of each health exchange web site. Oregon California Washington 11,700 individual 1 Given $180.3M. 1 Operational slighty late. 1 Given $909M. rules affect 1 Operational eligibility for health insurance on time. subsidies. Connecticut Kentucky 1 Writing the eligibility rules engine took 12 people nine months. 1 Estimated cost 1 Given $107M. 1 Given $153M. 1 Operational on time. 1 Operational on time. of $54M. 1 Paper only on Oct 1, site operational in mid October New York Idaho 1 Given $400M. 1 Given $68M. 1 Operational on time. 1 System due early 2014. Minnesota, Nevada and Rhode Island 1 Operational on time, but issues connecting with Federal data hub. Source: kff.org/state-health-marketplace-profiles/ www.nytimes.com/2013/10/09/us/politics/uninsured-find-more-success-via-health-exchanges-run-by-states.html 10 Why build a Government insurance exchange if there already are private ones? Unclear 1 Private exchanges I However, private exchanges can now sell ACA-compliant plans WITHOUT subsidies. I Stumbling block: private exchanges also can't access will later be able to offer subsidized plans. data hub to determine subsidies. 1 34 were added in 2013. Sources: www.cnbc.com/id/100925732 www.cnbc.com/id/101153131 How does the Government perform on other IT projects? 11 GOV +8% NON GOV I More productive than non-government projects. I The speed of delivery 1 On average, Government projects are being delivered 37% later than of Government projects is slightly better, (measured by the number of function I More functionality was delivered their delivery estimate and 22% points delivered in a month) of projects exceed their cost estimate. per developer hour. Source: www.totalmetrics.com/function-points-downloads/Software-Productivity-Government-ISBSG.pdf 12 Are there recent, successful Government Web IT projects? National Broadband Map Federal Communications How's My Waterway Commission/National Environmental Telecommunication and Protection Agency. Information Administration. Supertracker USDA Food Nutrition Self-Service Logon Remote Proofing Defense Manpower Data Center. and Consumer Services. Medicare.gov Responsive Design Centers for Medicare and Medicaid Services Arlington National Cemetery Explorer Arlington National Cemetery Source: annual GCN awards 13 When do Government projects succeed? Incremental delivery Expectations management Team empowerment Strong leadership Credible upfront estimates We make IT projects more successful Brought to you by Galorath Incorporated, producers of SEER-SEM and SEER-IT SEER by G A L OR ATH galorath.com 2012 2013