Wednesday, January 21, 2015

What Is the Plan B for Healthcare.gov's IT Problems

While Obamacare skeptics have glommed onto this government document for all the usual reasons of partisan advantage, the Disease Management Care Blog has a different take.

Titled "Justification for Other than Full and Open Competition," its ultimate purpose is to justify the non-compete and hurry-up hiring of IT company Accenture to fix the star-crossed healthcare.gov web site. It makes for interesting reading, with scary references to "the entire healthcare reform program [being] jeopardized" by "inaccurate... payments" to health insurers "potentially leading to their default" as well as "inaccurate forecasting of risk adjustment, reinsurance and risk corridor[s]" "potentially putting the entire health insurance industry at risk."

The deadline for the fix is less than two months away in "mid-March 2015" with an additional taxpayer cost of $91.1 million.

1) The DMCB doesn't mind a little bit of bureaucratic alarmism to justify the cutting of some red tape.  The considerable back-end transaction errors and reconciliation issues of healthcare.gov need to be fixed and the Justification is a refreshing alternative to CMS's wildly political pablum.  Good for them.

2) Check out the last two pages of the document and you'll find separate authorizing signatures from a "Project Officer," "Immediate Supervisor," "Head of the Sponsoring Program Office," "Contracting Officer," "Cognizant Group Director," "Cognizant Policy Director," "Director 'OAGM,'" "Competition Advocate" and "HHS Senior Procurement Executive."  Despite the vulnerability of the U.S. health insurance market and the threat to the credibility of healthcare.gov, nine signatures were needed from relatively unknown government officials buried deep inside a vast government bureaucracy.

3) Worst of all, the document makes no mention of a Plan B.  If the President's signature health health reform program is in jeopardy, what happens, asks the DMCB, if Accenture falls short?

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