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Galorath Inc. (the SEER Cost, Schedule, Risk Model Developers) watched the healthcare.gov rollout difficulties, the outcries and finger pointing and decided to take a more analytical look. While it is easy to throw stones at stakeholders, this was a huge IT project and there were bound to be challenges. Could it have gone better? Sure. Were there adequate resources? Seems so. Should testing and quality assurance been more rigorous? Yes, but there didn’t appear to be adequate time. Were the requirements firmed up in advance? That could have been a significant contributor. We are confident that healthcare.gov will recover and this will go down in history as another IT lesson learned. Using our SEER models up front could have shown the minimum possible schedule as well as costs and risks. This foresight could have helped the government and suppliers to do better to plan for the inevitable defects. Tracking progress with SEER could have also provided an early warning indicator… Probably early enough that corrective actions could have helped. by Galorath.com - http://www.galorath.com
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NOVEMBER2015
0.5
0
1.0
1.5
2
MILLIONHOURS
THOUSANDDELIVEREDDEFECTS
MONTHS FROM ESTIMATE-6 -5 -4 -3 -2 -1 1 2 3 4 5 60
1
0
3
4
5
2
2013
2012
IdentityManagement
User
Data HubGovernment
System3rd PartyInsurers
UserUser
Extreme numberof legacy systems,inside Government
and among3rd parties
Different rulesfor different
states
Citizenshipcertificationand incomeverification
A volatile environment withnumerous starts and stops:
Supreme Court, Presidentialelection, extreme
political disagreement
Complexeligibility rules
Numerous, powerfulstakeholders:the President, insurancecompanies, states, Congress
Halfof Android 4.0
(2011)
One tenthof Quickbooks
(2012)
A teeny fractionof Facebook
Registration requirementadded very late in development
Assuming....
10-30 major systems
$18K average monthly contractor cost (government rates)
500,000to 600,000lines of code
Or about 24,000unadjusted
function points
in other words...
Not enough time
Not just anothereCommerce site!
About $150M
Unclear
2,500 defectsat delivery
About 1.3MILLION
HOURS
Takingjust over2 YEARS
Historical insurancesovereignty within states
State-specificinsurance markets
Source: www.gao.gov/assets/660/655291.pdf page 38
Source: Galorath’s SEER-SEM Estimation Model
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/
Source: www.washingtonpost.com/blogs/wonkblog/wp/2013/02/18/its-official-the-feds-will-run-most-obamacare-exchanges/
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
Source: www.totalmetrics.com/function-points-downloads/Software-Productivity-Government-ISBSG.pdf
Source: annual GCN awards
Sources: www.cnbc.com/id/100925732www.cnbc.com/id/101153131
1,700 individualrules affecteligibility forhealth insurancesubsidies.
Writing the eligibilityrules engine took12 peoplenine months.
Estimated costof $54M.
Paper only on Oct 1,site operationalin mid October
Oregon
How’s My WaterwayEnvironmental
Protection Agency.
Medicare.govResponsive Design
Centers for Medicareand Medicaid Services
Self-Service LogonRemote Proofing
Defense ManpowerData Center.
National Broadband Map Federal CommunicationsCommission/NationalTelecommunication andInformation Administration.
Arlington NationalCemetery ExplorerArlington NationalCemetery
SupertrackerUSDA Food Nutritionand ConsumerServices.
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-1/240003694www.wired.com/wiredenterprise/2013/04/facebook-windows/
Default to Federal Exchange
Planning for Partnership Exchange
Declared State-based Exchange
Given $909M.Operationalon time.
California
AZ NM
TX
OK
KSCO
NE
KY
CAMO
OR
WA MT
WY
ID
ND
SD
MN
IA
IL IN
MI
OH
WV
VA
NC
ME
PA
NY
NHVR
AR
LA
FL
TN
NV UT
AK
HI
WI
CT
RIMA
NJ
DE
MD
DCMS AL GA SC
Given $180.3M.Operationalslighty late.
Washington
Incrementaldelivery
Expectationsmanagement
Teamempowerment
Strongleadership
Credible upfront estimates
Given $107M.Operationalon time.
Connecticut
Given $153M.Operationalon time.
Kentucky
Operationalon time.
Given $400M.
New York
Given $68M.System due early 2014.
Idaho
Operational on time, but issues connecting with Federal data hub.
Minnesota, Nevada and Rhode Island
However, privateexchanges can nowsell ACA-compliantplans WITHOUTsubsidies.
34 were added in 2013.
More productivethan non-governmentprojects.
More functionalitywas deliveredper developer hour.
The speed of deliveryof Governmentprojects is slightlybetter, (measured bythe number of functionpoints deliveredin a month)
On average,Government projectsare being delivered37% later thantheir deliveryestimate and 22%of projects exceedtheir cost estimate.
Stumbling block:private exchangesalso can’t accessdata hubto determinesubsidies.
Private exchangeswill laterbe able to offersubsidized plans.
+8%
NON GOV
GOV
Source: Galorath’s SEER-SEM Estimation Model
Under The Hood of Healthcare.gov1
Why did healthcare.gov have rollout problems?2
What were the states’ web site experiences?Amounts Include all ACA rollout costs in each state, generally more thantwice the cost of each health exchange web site.
9
When do Government projects succeed?13
How much has been spent on Healthcare.gov?3
How much does $150M buy?4
Why did some states develop their own exchanges?7
Which states developed their own exchanges?8
What kind of quality is delivered on delivery day?5
Why build a Government insurance exchangeif there already are private ones?
10
How does the Government performon other IT projects?
11
Are there recent, successful GovernmentWeb IT projects?
12
How much software can you buy for $150M? 6
Brought to you by Galorath Incorporated, producers of SEER-SEMand SEER-IT
galorath.com
We make IT projects more successful
Understanding Healthcare.gov’s
ROCKY
ROLLOUT
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