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Sebelius testifies on federal health insurance exchange ‘debacle’

In a much-anticipated Capitol Hill hearing on Wednesday, Secretary of Health and Human Services Kathleen Sebelius testified before the House Energy and Commerce Committee on the failures of the federal health insurance exchange website.
 
The hearing, which veered far from the infrastructure of the website to the larger structural failures of the Affordable Care Act, took on a predictable tenor with incredulous Republicans grilling the defensive former governor of Kansas, as her fellow Democrats on the committee took a more conciliatory tone. For anyone who has been following the Obamacare saga, the secretary’s testimony offered limited new information. Here is a synopsis of what we learned at yesterday’s hearing:
  • The buck stops with Sebelius, as she advised both Congress and the American public to hold her responsible.
  • The secretary found the entire website experience a “miserably frustrating … debacle,” for which she apologized to the populace while advising them that no delay in enrollment is necessary as the website is fixable.
  • Sebelius believes that when it is judged “by any fair measure,” the Affordable Care Act is working.
  •  Privacy and security concerns are legitimate and are being addressed by the fix currently underway for the website. 
  • HHS spent $118 million on the contracts to develop the Healthcare.gov website, with another $56 million in IT spending to support the website.
  • HHS has a total obligated contract in the amount of $197 million with CGI through March 2014.
Aside from those above, one more revelation seemed to expose the root of the website’s problem. The secretary reported that QSSI was brought in as the systems integrator after the website launched. Sebelius reported that the company had done excellent work with the Federal Data Hub and she believed it would repeat that performance in fixing the structural problems plaguing the system. This begged the question: Who was the system integrator in charge of the project during the run-up to the exchange launch?
 
Sebelius revealed, after intense questioning from a Republican congresswoman, that a team from the Centers for Medicare and Medicaid Services (CMS) operated as the system integrator at the time of launch. The team, headed by CMS Chief Operating Officer Michelle Snyder, was quite obviously deficient in this role and was rightfully replaced by a proven contractor.
 
Analyst’s Take
 
Politics runs rampant in any discussion of the Affordable Care Act. As one of the most sweeping and contentious pieces of legislation in modern history, this comes as no shock. In the nearly five years since insurance reform became a topic of conversation, not a single elected Republican on the national level has expressed support for the ACA. Some provisions have gained Republican approval in the states, but the thrust of one-half of the political system has clearly been to scrap the law and start over.
 
Enter October 1, 2013. The website launch was a bust. Millions of individuals with insurance on the individual market realized, as the Fact Checker Column in the Washington Post points out, that they could not in fact keep their plans. With that as the backdrop, it is no wonder that many lawmakers are out for blood. Still, through all this noise emerge concrete lessons for governments and vendors alike.
  • The alignment of system implementation deadlines around a political calendar often hinders success. Since the passage of the law, the vendor community knew the deadline for exchange implementation on the state and federal level was unrealistic. Yet, absent a more plausible explanation, it seems politics dictated a steadfast deadline of October 1, 2013, for the exchanges to be operational. 
  • The micromanagement of the website launch by the CMS team, ostensibly unqualified for such an involved task, was a poor move with such tight deadlines. Though needing more time for an excellent product delivery, the private sector could have grudgingly met the stringent deadline with, at the very minimum, a functioning website. 
  • The criticism of the cost of the contracts to implement the website has gained traction only because it doesn’t work. Had the website worked on day one, those who criticize the amount paid to vendors for the build would have been neutered by the success of a signature feature of the ACA. The large amount of taxpayer dollars required to build such a complex infrastructure is understandable only if the infrastructure is a success. Absent that success, greater spending scrutiny occurs from politicians and journalists to accentuate tales of failure. 
Finally, it is clear the website will be fixed, eventually. The question becomes: To what end does all this bad press prevent the overall success of the ACA? From the perspective of state government, it seems clear that this debacle is not going far to convince the reticent majority of governors who rejected a state-run exchange. As time goes on, we will see if those leaders will use the federal experience as a warning shot of the perils inherent in implementing a flawed system, or as inspiration for how not to proceed as they take up the exchange mantle.

 

GovWin Recon - October 31, 2013

GovWin Recon, produced by Deltek's Federal Industry Analysis (FIA) team, is designed to support awareness and understanding of the issues impacting the government and the contractors that serve it. Recon highlights key developments surrounding government technology, policy, budget and vendor activities.

Headlines beginning with an * include quotes from Deltek analysts. 

 

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Agency News:

Vendor News:

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GovWin Recon is Deltek's daily newsletter highlighting federal government contracting news and analysis from around the government contracting world. Get it delivered to your e-mail inbox, free!

 

 

CMS Slow to Change ID Numbers, Leaving Medicare Beneficiaries Vulnerable to ID Theft

A new GAO report shows that Medicare beneficiaries may be at risk for identity theft due Social Security Numbers (SSN) printed on Medicare cards.  An estimated 50 million Medicare insurance cards include printed SSNs. 


CMS uses SSNs as the beneficiary’s unique identifying number.  Private insurers have abandoned the practice due to privacy concerns.  Use of a person’s SSN as a printed ID number, makes them vulnerable to identity theft.   CMS has been studying how to correct the problem.  GAO was asked to review CMS’s efforts to date. 


CMS has identified two possible approaches for removing SSNs, replacing them with new identifiers or masking all but the last four digits of the SSN on cards.  CMS has also explored, at a high level, the IT system changes that would be necessary to implement either solution.  However, GAO found that CMS has not designated a business owner or established a business case for an information technology (IT) project.  According to CMS officials, agency leadership has not directed them to initiate such a project.


“While CMS has spent time and resources over the past seven years studying approaches that could be taken toward removing the SSN from Medicare beneficiaries’ cards, the agency has not actively established and pursued a goal to identify an IT solution for doing so,” GAO said.

 

GAO proposed that CMS use in-process upgrades to its IT infrastructure as an opportunity to include improvements that would make it easier to remove SSN numbers from cards.  Previous assessments of CMS’s IT environment have found that it consists of many aging, “stove-piped” systems that cannot easily share data or be enhanced.  In addition, officials say, replacing the cards will likely cost the agency millions of dollars.


Between 2004 and 2011, DoD and VA phased out printed SSNs on almost 18 million cards, and switched to a system of storing the information on bar codes or magnetic strips.  DoD and VA are still planning to phase out use of SSNs.


HHS agreed with the goal of removing SSNs from printed cards, but said it needs cooperation from SSA and the Railroad Retirement Board where they have data sharing agreements. 


Contractors should watch this issue and look for potential opportunities that might arise for removing SSNs from Medicare cards, as well as CMS system changes that will need to accompany the effort.

 

GovWin Recon - October 30, 2013

GovWin Recon, produced by Deltek's Federal Industry Analysis (FIA) team, is designed to support awareness and understanding of the issues impacting the government and the contractors that serve it. Recon highlights key developments surrounding government technology, policy, budget and vendor activities.

Headlines beginning with an * include quotes from Deltek analysts. 

 

Federal IT:

Agency News:

Vendor News:

Cybersecurity:

Health IT:

Mobility:

Defense / C4ISR / Embedded Technology:

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Legislation:

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GovWin Recon is Deltek's daily newsletter highlighting federal government contracting news and analysis from around the government contracting world. Get it delivered to your e-mail inbox, free!

 

 

Chasing Army Advanced Computing Investments

Since the end of the government shutdown last week Army officials have been out and about sounding their frustration about the impact that sequestration is having on Army programs and troop readiness.  Full public venting of their concerns came out at the 2013 Association of the United States Army Annual Meeting and Exposition.  Army Secretary McHugh and Chief of Staff General Ray Odierno stated that many of the Army’s modernization programs are in serious danger from budget cuts.  Army acquisition chief, Heidi Shyu stated, however, that some investment will continue in the Army’s Science and Technology (S&T) portfolio.  Rickey Smith, Director of the Army Capabilities Integration Center—Forward, provided further details, noting that the Army’s S&T investment strategy focuses on human performance, advanced computing, and material sciences.  It is the advanced computing piece of this equation that I’ll dig into in today’s post.
 
Advanced computing investments fall under the Army’s Research, Development, Test, and Evaluation (RDT&E) budget request.  For Fiscal 2014 these investments include one project called simply “Advanced Computing,” and two other projects that include advanced computing elements.  These other projects are “Power Electronics, Hybrid Electric, and On-Board Vehicle Power (OBVP) Components” and “Command and Control (C2) On-The-Move (OTM) Enabling Technologies.”
 
Looking over the “Advanced Computing (AC)” project description it seems clear that this is a big data applied research project with the goal of investigating “computing and networking architectures, algorithms, [and] visualization for advanced C4I battle command applications.”  AC has been underway for a couple of years and in FY 2014 the planned investment is $3.75 million.  Planned activity centers on “exploring uncertainty quantification based mathematical approaches to assist the verification and validation methodologies.”  The program will require the vendor to work closely with the Army’s Communications-Electronics Research, Development, and Engineering Center (CERDEC) and Army Test and Evaluation Command (ATEC) to develop “scalable programming models and software developed for [the] tactical computing concept.”
 
As for the planned OBVP investment, this project focuses on developing next generation portable power sources for vehicle platforms to enable the use of on-board advanced computing and other power-hungry technologies.  The work required entails laboratory testing of proposed solutions to investigate the viability of “high temperature power electronics compared to traditional power electronics for power generation.”  Requested funding for this project in FY 2014 amounts to $2.41 million.
 
Lastly, the C2 OTM investment “investigates, designs, and codes software to improve the Warfighter's ability to access, use, present, and understand relevant mission command information.”  The effort focuses on developing “software and algorithms to increase unmanned platform autonomy and improve multi-platform autonomous collision avoidance” to improve mission command capabilities.  The planned investment for this project in FY 2014 is $9.95 million.  Presumably the industry partner would be required to work with PEO Command, Control, and Communications-Tactical (PEO C3T) on this effort.
 
None of these investment amounts is staggeringly large, but in today’s fiscal environment every cent counts.  If the Army says these are areas where spending will continue, then vendors are well advised to follow the breadcrumb trail.  Further research did not turn up any contract opportunities specifically related to these investments so there is hope that competitions for contracts are still pending.  Those interested should be aware that at least some of this work could be related to contract #W15P7T13D0054 awarded to DRS Technologies in June 2013 for Production of the Mounted Family of Computer Systems (M-FOCS) Hardware.  There is a software component to the DRS contract, but for the most part it appears to be a hardware-focused effort.

 

GovWin Recon - October 29, 2013

GovWin Recon, produced by Deltek's Federal Industry Analysis (FIA) team, is designed to support awareness and understanding of the issues impacting the government and the contractors that serve it. Recon highlights key developments surrounding government technology, policy, budget and vendor activities.

Headlines beginning with an * include quotes from Deltek analysts. 

 

Federal IT:

Agency News:

Vendor News:

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Cloud Computing / Data Center Consolidation / Virtualization:

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Transparency and Performance:

Waste, Fraud and Abuse:

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GovWin Recon is Deltek's daily newsletter highlighting federal government contracting news and analysis from around the government contracting world. Get it delivered to your e-mail inbox, free!

 

 

 

 

CGI in the hot seat for countless issues with the federal HIX

You could be living under a rock if you have yet to hear the criticism the Department of Health and Human Services (HHS) and CGI are getting on the rather flawed federal insurance exchange portal. The website has been crashing left and right, and many individuals have been unable to sign up for health plans as hearings continue to take place amongst HHS members and CGI contractors. The latest hearing seemed more of a grilling, as representatives from numerous states extensively questioned CGI’s work on the federally facilitated model. Many questions surfaced regarding the amount of testing that was done prior to its release, in addition to other elements.

CGI put much of the blame on HHS for problems with the system, claiming the department’s overall coordination of the project was poor. According to Cheryl Campbell, CGI senior vice president, CGI’s portion of the application worked as projected; however, HHS failed to conduct the extensive performance testing that was needed. She later highlighted the point that CGI had no say in when the system went live, and that it was essentially out of her company’s hands.

There is no question that the tight timelines surrounding the build out of these exchanges has much to do with post-launch problems. States were given very little guidance as to how the systems should look, which was largely due to the feds not knowing either, since the idea was so new. However, with the massive amount of issues the federal exchange is having compared to states that opted to build a system on their own – was the state-based model a better idea? The answer to this question will hopefully be answered soon, when the number of people enrolled in the federal exchange can be compared to the number enrolled in state-based exchanges. For now, Deltek thought it would be interesting to take a look at some of the work CGI has done in building out state-based exchanges, and their level of success.

Massachusetts

The commonwealth of Massachusetts signed a $66 million contract in July 2012 with CGI for its next phase HIX and integrated eligibility system (IES). However, Massachusetts is no stranger to exchanges, as health care reform started in the state in 2006 with the creation of the Massachusetts HealthConnector, under Dell. Changes for Massachusetts included the end of Commonwealth Care as the state transitioned to federally qualified health insurance plans under the ACA. Reports available detailing Massachusetts’ exchange seven years ago stated that enrollment really didn’t flesh out until a full year had passed, but the mandate was a year away from the go-live date. Insurance shoppers were also heavy site utilizers, visiting the exchange roughly 20 times before making a purchase. The focus for officials in Massachusetts in 2007 wasn’t enrollment on a daily basis, but the long-term potential of an exchange system and its health benefits to the population.

Colorado

The Colorado Department of Health Care Policy and Financing awarded CGI in May 2012 for the complete build out of its insurance exchange. According to Patty Fontneau, CEO of “Connect for Health Colorado,” the website has remained active and people have been able to shop and compare almost 100 percent of the time. The site also includes features that allow individuals to download information into an Excel spreadsheet to compare plans offline.

Hawaii

The Hawaii Health Connector awarded CGI in December 2012 to build out its exchange. The state experienced a considerable amount of issues with the website compared to other states, which delayed consumer enrollment by two full weeks. Prior to this, the site was not displaying prices and consumers were unable to compare and shop for health plans. Though the site is up, some consumers complain that the site is “confusing” and “not easily navigable.”

Illinois

The Illinois Department of Insurance very recently (August 2013) awarded a $$66.5 million contract to CGI to build an insurance exchange system that would interface seamlessly with not only the federal hub, but the state’s current integrated eligibility system (IES). The initial launch of GetCoveredIllinois.com went pretty smoothly. Unlike the federal exchange, the state-based portal experienced virtually no issues. The state also recently launched a Spanish-language website to assist the needs of the Latino population.

Vermont

Vermont contracted with CGI in December 2012 for its health benefits exchange (HBE), valued at approximately $51 million. The state was already in the process of architecting a new health and human services platform using Oracle technology. There have been reports of technical issues and computer system glitches with the Vermont Health Connect, with state Republicans calling for a delay in the exchange mandate. Governor Peter Shumlin has stated that performance is improving and that the number of Vermonters fully enrolled in health insurance through the exchange has grown by 75 percent in the past week. One of the major issues is not being able to pay for policies online at this time.

Kentucky

Although there has been talk regarding the relative success of Kentucky’s HIX over the federal exchange (as articles say they both used CGI), Kentucky’s $101.5 million HIX contract is with Deloitte, with CGI providing plan management and the billing solution. The state’s exchange, Kynect, has enrolled more than 15,000 people since October 1. The first day was not without technical problems, but state staff addressed IT needs. Governor Beshear has stated that there have been nearly 280,000 unique visitors to the site, and more than 66,000 calls to the Kynect hotline.

Analyst’s Take 

The higher success rates seen in these states that chose to utilize a state-based model suggest that development and implementation may have been carried out much better with the help of CGI. Perhaps these states were able to have more oversight of the project, which allowed for better planning and more testing. Vendors can expect to see states reaching out to contractors to help fix glitches in their systems as they arise.

Moreover, visible success of state-based exchanges over the federal marketplace could start the ball rolling on exchange transitions, especially given federal, vendor, and expert views of 2016 being the key date for the migration of federally-dependent states to state-based models. 

Stay tuned for an extensive report on the insurance exchange market! Not a Deltek subscriber? Click here to learn more about Deltek's GovWin IQ service and gain access to a free trial.

 

GovWin Recon - October 28, 2013

GovWin Recon, produced by Deltek's Federal Industry Analysis (FIA) team, is designed to support awareness and understanding of the issues impacting the government and the contractors that serve it. Recon highlights key developments surrounding government technology, policy, budget and vendor activities.

Headlines beginning with an * include quotes from Deltek analysts. 

 

Federal IT:

Agency News:

Vendor News:

Cybersecurity:

Cloud Computing / Data Center Consolidation / Virtualization:

Health IT:

Defense / C4ISR / Embedded Technology:

Contracting / Acquisition:

State and Local:

AEC News:

GovWin Recon is Deltek's daily newsletter highlighting federal government contracting news and analysis from around the government contracting world. Get it delivered to your e-mail inbox, free!

 

 

GovWin Recon - October 25, 2013

GovWin Recon, produced by Deltek's Federal Industry Analysis (FIA) team, is designed to support awareness and understanding of the issues impacting the government and the contractors that serve it. Recon highlights key developments surrounding government technology, policy, budget and vendor activities.

Headlines beginning with an * include quotes from Deltek analysts. 

Sequestration / Budget:

Federal IT:

Agency News:

Vendor News:

Cybersecurity:

Cloud Computing / Data Center Consolidation / Virtualization:

Health IT:

Waste, Fraud and Abuse:

Defense / C4ISR / Embedded Technology:

Contracting / Acquisition:

State and Local:

GovWin Recon is Deltek's daily newsletter highlighting federal government contracting news and analysis from around the government contracting world. Get it delivered to your e-mail inbox, free!

 

 

 

 

Changing with the Time

This year’s IT Solutions Management for Human Services (ISM) Conference, “Navigating the Course,” held in sunny San Diego, California, focused heavily getting technology to change with the time. Tracy Wareing, executive director for ASPHA during the opening presentation, put it as navigating to a “new normal”. This includes connecting all health and human services (HHS) programs in order to achieve a modern HHS, so that people can get the right service, at the right time.

Another major component to the “changing with the time” idea referenced throughout the conference was utilization of mobile applications. During a session titled, “The Digital Future: Opportunities and Trends in Using Mobile Technology to Support Service Delivery”, Aaron Smith, representative from PEW Research Center, shared some interesting statistics about the growing use of mobile technology. According to results from a recent study conducted by the research center, 57% of American adults use their cell phone to go online. Also, 21% percent of cell phone owners do a majority of their internet browsing on their phones as opposed to computers. Smith highlighted in his presentation how this increased reliance on mobile devices is setting the stage for how much of a staple this technology is in individuals’ lives- even people in lower socioeconomic groups. For that, health and human services agencies must start moving toward this way of delivering services.

The 2013 ISM conference was full of additional valuable information for both private and public sector communities. Breakout sessions were split among the following tracks: new service delivery models, health care reform, emerging technologies, best practices, and data analytics. Be sure to download a copy of Deltek’s latest recap that provides an in-depth look at themes gleaned from this year’s premiere event!

Not a Deltek subscriber? Click here to learn more about Deltek's GovWin IQ service and gain access to a free trial.

 

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