Upload
proteus-duxbury
View
46
Download
0
Tags:
Embed Size (px)
Citation preview
From Build to Run at the Colorado Health Insurance Marketplace July 21, 2014
Proteus Duxbury, CTO
Connect for Health Colorado
2
…unknown
3
Helping to make Coloradans smile
4
4
12
What is Connect for Health Colorado?
An open, competitive marketplace for individuals and small employers to: • Shop health plan features • Compare information regarding
cost and quality • Determine eligibility for and
access financial assistance • Support network access,
including service center, health coverage guides and brokers
• Enroll in a health plan
Shop for Plans
5
Choice – Individual Marketplace
150 Health Plans
22 Dental Plans
6
Choice – Small Business Marketplace
92 Health Plans
45 Dental Plans
7
We have enrolled 139,000 consumers
8
We have a varied and mixed pool of enrollees
9
Our marketplace users are very active
10
Systems are performing well under load
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
1-Oct 16-Oct 31-Oct 15-Nov 30-Nov 15-Dec 30-Dec 14-Jan 29-Jan 13-Feb 28-Feb 15-Mar 30-Mar 14-Apr
Volume
Median M-F
12
Strong leadership has been critical to our
success
• Leadership & team
o Shared vision
o Empowered to make decisions
o Start-up culture
o Skilled and highly dedicated team
• Flexible vendor
o Agile with rapidly changing regulatory
requirements
o Committed to achieving success
o Strong contract and definition of requirements
• COTS solution
o Minimal customization and custom development
o Scope control
o Leading HIX suite
o Best of breed around the edges
o Highly resilient and available architecture
o Secure
Vendor Solution
Team
LEADERSHIP
13
We have a 3 year roadmap to move from build
to run
2015 – THEN “STABALIZE” Implement the ‘run’ strategy. Stabilize the
technology in production and reduce overall
technology spend in line with sustainability
targets. Moving to a variable IT cost where
possible.
2016 – FINALLY “REACH THE
SUMMIT” Business as usual technology operations.
Predictable ‘run’ environment with ability to
deliver on new project requests efficiently.
2014 – FIRST “BUILD” Complete the implementation of the
marketplace and eligibility system builds as
planned. Develop ‘run’ strategy.
Base
Camp
Start
• All ITIL processes fully deployed
• Continuous improvement program in place
• Metric driven IT organization
• Predictable IT cost base
• Innovation
• Full sourcing strategy benefits realization
• Ongoing innovation and enhancement
• ITIL implemented
• Architecture enhancements deployed
• Key contracts renegotiated, sourcing re-
balanced
• Operational cost base established with
variability where possible
• API implemented
• Consulting support significantly reduced
• 1.x marketplace functionality deployed
• Release 2.0 marketplace functionality deployed
• Shared Eligibility System deployed
• IT strategy developed
• Sourcing strategy / new SLAs documented
• C4 IT Team fully resourced
• Architecture review and roadmap
• Capacity planning
13
14
Why architecture is important!
15
Why are we building an architecture roadmap?
• Reduce M&O expense
• Consolidate architecture and gain efficiencies
• Continue to meet key SLAs
• Operationalize IT
• Stabilize foundations as a platform for future
growth
• Align technology investments with business
goals
• Motivate new team
16
A quick poll – setting and documenting goals
• Group 1 was asked to simply think about the business-related
goals they hoped to accomplish
• Group 2 were asked to write their goals
• Group 3 was also asked to write action commitments
• Group 4 had to both write goals and action commitments and
also share these commitments with a friend.
• Group 5 did all that and sent a weekly progress report to a
friend.
43%
64%
76%
Psychology professor Dr. Gail Matthews
17
Do you ever feel like this?
18
Challenges in building out the roadmap
• Budget is a constraint
• There are many federal requirements we must meet
• Multiple partner engagement
• Multi-vendor environment
• ‘Startup in a fishbowl’
• Delivering while planning
NAME OF
PRESENTATION
|
19
High level roadmap approach
20
• Loosely coupled Technology Agnostic Design (TAD)
• Enterprise COTS solutions over custom developed solutions
• Best of breed where strategic
• Pay for compute
• Data entered once and shared across systems (single source of truth)
• Use State data sources for verification
• Low M&O impact architecture
• ROI driven architecture
Key C4 Architectural Principles
20
21
We started by mapping our business capabilities
Business capabilities map L2 Key: L1 Business Capability Map
7. Conduct Core Operations
Enrollme
nt
7.2
Manage Billin
g
Syste
m
Sharin
g
7.7
Manage Government
Program Encounte
rs
7.0 Business Management and Shared Services
7.3 Manage IT Services
7.4 Manage Financial
Operations 7.5 Manage Procurement
7.7 Manage Compliance,
Legal, Regulatory
7.9 Manage
7.2 Manage Enterprise
1. Develop
Product
1.1
Implement Product Strategy
1.2
Design Products
1.3 Manage
Ancillary
Services
Actuari
al Servic
es
Member
2. Plan Management
2.1 Establish Issuer and
Plan Details
2.2 Monitor Plans
2.3 Manage Plan
Management Rules
5. Communications
5.1 Manage Outreach
5.3 Manage Notifications
5.2 Manage
Communication Rules
4. Customer Service and
Account Management
4.1 Manage Customer
Support
4.2 Manage Enrollee Survey
4.4 Manage Rules
4.3 Manage Broker /
Navigator Relationship
1. Enrollment and
Eligibility
1.1 Manage Individual
Eligibility & Enrollment
1.2 Manage Individual
Responsibility
Exemption
1.3 Manage SHOP
Employer Eligibility and
Enrollment
1.4 Manage SHOP
Employee Eligibility&
Enrollment
3. Financial Management
3.1 Transaction Processing
3.2 Risk Management
3.4 Rules Management
3.3 Payment Monitoring
3.5 Reporting
6. Oversight
6.1 Governance and
Management Support
6.2 Human Resource
Management
6.3 Assets Management
6.4 Knowledge and
Information Management
7.6 Manage Vendors
1.5 Manage Appeals
7.1 Manage Channel
Interfaces
7.8 Manage Internal Audit 7.9 Manage Public Relations 7.10 Manage Continuous
Quality
22
… and aligned our application portfolio against them
22
23
Our roadmap has a series of transitional
states
24
Our roadmap has a series of transitional
states …
25
26
Key elements of the roadmap
• Release 2
• Cloud
• Mobile
• APIs
• Decision support
• Integration
• Architecture enhancements
• Data quality / governance
• New products
Need
Help?
27
Some lessons learned along the way
• Without a burning platform the chance of
failure is high
• Speak a language the business can
understand … Don’t use the ‘A’ word
• Continually demonstrate ROI
• Business design is critical
• Be tactical and strategic
• Don’t be afraid to make tough decisions
… and stick to them
28
Thank you!
Any questions?
Proteus Duxbury
CTO
Connect for Health Colorado
E-mail: