Government // Leadership
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1/14/2014
02:45 PM
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Accenture Jumps Into HealthCare.gov Hot Seat

CGI Federal's mishandling of federal health exchange website paved the way for Accenture Federal Services.

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7 Portals Powering Patient Engagement
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The dismissal of HealthCare.gov's lead contractor, CGI Federal, by the Centers for Medicare and Medicaid Services (CMS) and the agency's decision to hire Accenture Federal Services mark the latest effort by CMS to move beyond the management missteps that have plagued the online health exchange website since its launch last October.

The decision comes as CGI Federal's contract to manage HealthCare.gov's development was up for renewal at the end of February. Facing a barrage of criticism, CMS officials elected not to renew the contract, although CGI Federal will continue to have plenty of work with CMS. CGI Federal, however, has also taken hits for the contractor's work on the health exchanges for Massachusetts and Vermont. Both states froze payments to the company in late December, and said funding would not resume until the company met its contractual obligations.

Accenture comes in as new player in the HealthCare.gov lineup, although its record for building and maintaining large-scale, public-facing government websites for the IRS, the US Census Bureau, and the US Department of Education was one of the reasons behind CMS's decision to award the consulting giant a one-year contract. Accenture has also carved out a reputation for understanding the workings of the healthcare industry, and is credited with bringing California's healthcare insurance exchange online without the problems other states have experienced.

[Read our complete coverage of the HealthCare.gov launch here.]

In its new role at CMS, Accenture will be responsible for around-the-clock support of applications made on federally facilitated marketplace, including eligibility and enrollment functions, generating and transmitting the enrollment forms, and other services. The company will also lay the foundation for the next round of open enrollment, which starts in October.

The initial phase of the contract is worth $45 million; the final value of the contract will be defined by the mutually agreed-upon work plan, but by some estimates is expected to approach $90 million.

Accenture Federal Services Chief Executive David Moskowitz said the company's "deep healthcare industry insight as well as proven experience building large-scale, public-facing websites" will be play central roles in "improving HealthCare.gov."

 Courtesy of Accenture Federal Services
Courtesy of Accenture Federal Services

The announcement came just three days after Accenture won a $184 million contract from the Washington Metro system to provide a state-of-the-art fare payment system that will allow passengers to use existing SmarTrip cards, as well as chip-enabled credit cards, federal ID cards, and mobiles phones using near-field communications.

While the federal health exchange has garnered headlines across the country for its disastrous initial rollout and poor contractor management, state health insurance exchanges have encountered significant failings of their own.

Maryland's state-run exchange, for example, has had an abysmal start, based in large part because of feuding between the contractors undertaking the program. Maryland officials knew the project was going badly, but decided to let it go live on Oct. 1. The system promptly crashed, and still is not working properly. Maryland Gov. Martin O’Malley is working to get emergency legislation passed to allow uninsured residents to enroll in the existing Maryland Health Insurance Plan, normally reserved for high-risk individuals.

In addition to problems with the health exchanges developed for Massachusetts and Vermont, Minnesota Gov. Mark Dayton has criticized IBM for problems dogging that state's health insurance exchange, while Oregon's prime contractor, Oracle, has been criticized for the poor performance of that state's health exchange website.

Patience Wait is a Washington-based writer who reports regularly on government information technology for InformationWeek.

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cbabcock
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cbabcock,
User Rank: Strategist
1/15/2014 | 8:46:01 PM
Where is the skilled project management?
Experience across both the states and federal government shows the health care sites are tough to get up and running properly. Blaming only a high profile sub, but not the prime, contractor, as the Minnesota governor did, is scapegoating. You'd almost think a company is foolish for taking on the job, except for those large payouts involved. Good project management would at least keep tabs on progress and be able to single out those subcontracters who aren't meeting their responsibilties. But that too seems to be in short supply.
ThomasC213
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ThomasC213,
User Rank: Apprentice
1/15/2014 | 4:20:15 PM
Re: Accenture - Really???
Your company was doomed from the get-go if it was relying solely on the performance of a consulting firm. What about your companies job to manage the consultant work?  Were there no content and performance reviews?  Any company who blames their demise solely on the IT consulting services they received will be laughed at by everyone in the IT industry...

 
pbyrne
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pbyrne,
User Rank: Apprentice
1/15/2014 | 3:51:27 PM
Accenture - Really???
So the Feds have chosen to hire the company the sued itself to fix the Obamacare Quagmire?

I hope the Feds fare better than my previous employer which spent $14 million on hardware, software and consulting services only to receieve a long distance billing system which was vastly inferior to the homegrown system written by several good ole boys from South Alabama.  After $14 million and 18 months of Accenture's blunders my employer was forced to file for bankruptcy and shutter a $75 million business. I suppose that things could have changed over time, but I doubt that they've changed that much, but I suppose that that the cost of any blunders can always be passed on to the U.S. taxpayors.  
WKash
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WKash,
User Rank: Author
1/15/2014 | 3:20:21 PM
Re: Convenient
Todder, point well taken.  I agree, even though the states are different, the problems are the same.

 
Todder
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Todder,
User Rank: Moderator
1/15/2014 | 3:13:48 PM
Re: Convenient
@WKash ... If you write a flow chart there is nothing much different about the exchanges. Selectors would be comparable and really are just swaps of PII strings with feeds to backend registration database templates with reason checking. I agree it's huge, and part of the problem is port access and uptime. But as we say in Canada, the problem is the same, but different between states, and the fed.
WardD967
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WardD967,
User Rank: Apprentice
1/15/2014 | 1:27:25 PM
Accenture - splendid choice
I'm sure that they'll do a bang-up job.

http://www.contractormisconduct.org/index.cfm/1,73,221,html?ContractorID=5&ranking=68

http://wonderlandresearchers.blogspot.com/2014/01/obama-administrations-pick-to-run.html

http://www.justice.gov/opa/pr/2011/September/11-civ-1167.html

At this point, what difference does it make?

 

 

 

 
WKash
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WKash,
User Rank: Author
1/15/2014 | 1:25:49 PM
Re: Convenient
On your point about common templates: You have to remember that these insurance exchanges vary state to state because the insurance laws, health providers, and a host of other data variables also vary by state.  You can blame the Obama administration and health officials for not foreseeing that three dozen states would dump the work of building exchanges on the door step of the feds.  And while its fair to suppose there must be a number of common compoenents in these excchanges, setting them up and configuring them correctly for each state, and making sure all the connections work is a massive project management undertaking.

 
Todder
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Todder,
User Rank: Moderator
1/15/2014 | 12:33:20 PM
Re: Convenient
I dunno. Seems there's a pattern here regardless of who got the contract to provision the enroll site; federal or state. With the finger p;ointing it isn't odd that Accenture would get the contract given it is a major business partner and reseller for IBM wares.


Further, there should be a common template for this type of service and delivery. It would make adoption much simpler, downstream setup and admin faster and cheaper as the economies roll in,
Zman7
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Zman7,
User Rank: Strategist
1/15/2014 | 12:21:56 PM
Probably a good choice
Arthur Andersen should be able to fix this, but let's hope they don't run up the bill like CGI.
WKash
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WKash,
User Rank: Author
1/14/2014 | 4:18:10 PM
Convenient
Given recent reports on CGI Federal's history of performance on government website projects, CMS appears to be lucky that the CGI Federal contract was due up for renewal in February giving CMS a simple way to remove CGI from the HealthCare.gov project. That doesn't make it easier for CMS or for the contractors still on the project.  Now a new team moves in to pick up the pieces. CGI Federal, meanwhile, will certainly be paying more attention to getting the job done right on the rest of the projects it still has at CMS. 

 
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