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Oracle: Villain Or Scapegoat In Oregon Insurance Exchange Mess?
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David F. Carr
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David F. Carr,
User Rank: Author
3/10/2014 | 9:43:55 AM
Re: Oracle blameless in Oregon health insurance exchange fiasco?
@PDXnativeson So you're saying Oregon did a superior job of vendor and product evaluation, which led them to select Oracle foundation technologies as the basis of the state health insurance exchange? So where do you see things went wrong? You lost me at the end: "Their mistake was NOT issuing an RFP after they selected software first." What would a retroactive RFP have accomplished? Or are you really making a more general comment about the contracting process and the expectations that were set at the beginning? Requirements too much of a moving target?
David F. Carr
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David F. Carr,
User Rank: Author
3/10/2014 | 9:35:53 AM
Re: Oracle blameless in Oregon health insurance exchange fiasco?
Yes, the state bought some substantial commercial-off-the-shelf systems for database, CRM, and other functions as the basis for the health insurance exchange, but these were to be treated as components of the grand system. That's different from starting with a COTS insurance exchange product, even one targeted for a somewhat different usage scenario. There were some of these that had been created for use in private exchanges run by employers and consumer websites for people seeing insurance on the individual market, as well as products rolled out specifically to meet the requirement for states to field these systems.

California, for example, took advantage of software from GetInsured as a starting point.
PDXnativeson
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PDXnativeson,
User Rank: Apprentice
3/8/2014 | 3:08:57 AM
Re: Oracle blameless in Oregon health insurance exchange fiasco?
Everything Oregon bought from Oracle is COTS software... Siebel, OPA, PeopleSoft Financials, Oracle BI, Fusion Middleware, Oracle Database etc.
PDXnativeson
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PDXnativeson,
User Rank: Apprentice
3/8/2014 | 3:02:03 AM
Re: Oracle blameless in Oregon health insurance exchange fiasco?
First of all Sheehan is an idiot. Exeter was offering an additional configuration of the software the state already owns with no proven value. Exeter offers a configuration of Siebel CRM, Oracle Policy Automation and a custom LifeRay portal front end for the customer-facing portion of the site. The core of their configuration is Siebel, OPA, Oracle fusion middleware and LifeRay. Why would the state buy Exeter's configuration when Exeter's configuration gets them no further down the road? It would be a ridiculous waste of money. Calling Exeter's configuration of Siebel and OPA is not specific to Oregons business rules or resulting data model and.business workflows. And to say cover oregon is not using COTS software is incorrect. Their implementation uses Siebel Public Secotor and Siebel Financial Services which has support for OOTB functionality for plan management (health plan products and catalog), individual policies, group policies, broker/partner management, eligibility and enrollment with Oracle Policy Automation. For so e reason the state wanted a new exciting front end for the "customer portal" so they decided to add Oracle WebCenter Portal for the front end website look and feel which exposes web services communication to Siebel and OPA..., this is where the state requirements started to expand and be more custom than it should have been in the first iteration. If they would have simplified and not tried to do too much, they would be in better shape... They told a oracle what they wanted, Oracle warned them, but they wanted the full Monty anyway... Open Source is NOT the answer... What open source eligibility rules engine would you use? What open source call center would you use? What open source financial ERP package would you use? What open source marketing automation product is on the market? What open source software exists for health plan management? What open source pricing and product configuration engine is there? What open source CTI integration is there? What open source business intelligence is there? Siebel has OOTB CRM, sales force automation, call center, marketing automation, partner and broker lead and opportunity management, financial services and insurance policy management, lead and opportunity management, and pre-built business intelligence... And oracle policy automation is the market leading policy management and natural language business rules engine... So don't tell me there is no COTS software out there that can actually meet majore functionality across all 6 pillars of HIX. The reason why Curam dropped out of the bid is because the state required a 3-day deep dive as part of the Orals process where each vendor had to put their money where their mouth was. Curam is only eligibility and case management t for social services..., no SFA, no CRM, no I surance functionality, not data warehouse, no eCommerce product catalog, no financial ERp package... That's the reason they dropped out because they could not show up and demo anything relevant. Oregon is the only state at least where they did their due diligence in the vendor demo process... Not other state did a full 3 day evaluation with their short listed vendors... Anyone can walk in a give a credible demo for one day but Oregon users and IT staff actually got their hands on the keyboards to evaluate the vendor. Their mistake was NOT issuing an RFP after they selected software first.
Mr. Gigabob
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Mr. Gigabob,
User Rank: Strategist
3/7/2014 | 4:13:40 PM
Re: Oracle blameless in Oregon health insurance exchange fiasco?
CoverOregon was meant to be a a National demonstration for the potential of Obamacare, leveraging decisions at the heart of the Oregon Health Plan which was a major success of Governor Kitzhabers first two terms.  What made it more ambitious was its effort to tailor an applicants program offering based on tax policy, medicare levels, core reeccomended requirements and alignment with programs providing various levels of support.  In short - it was not a front-end to entering an e-application - but a complex health tool that was part enrollment agent, counselor, financial tool and vehicle to capture data on outcomes that would be used to improve general healthcare deliverables across systems.  Nobody else in the nation was thinking in these terms or scope.

Rep Sheehan's comments came late in the game and were earnest - but not constuctive efforts on how to make things better (a year into the program and lets use a new set of tools, capabilites etc).  These were seen as "get rid of Oracle - and by inference the team adminstering this effort".  Given there had already been calls to remove Lawson 6 months before by the Republican Legislator from Central Point - many of these critiques were brushed back by Lawson and her supporters as Anti-Obamacare rhetoric to cripple a project in progress that was going to be a singular beacon of accomplishment, demonstrating the forward thinking in Oregons original efforts to grapple with health care issues was no fluke.

I found critiques by Legislator Dennis Richardson - where he condemned Caroyln Lawson for witholding payment to the external auditor for the CoverOregon project after it provided a damning report on project ability to meet deadlines in the coming year to have been more to the point.  His EMAILs directly to Gov. Kitzhaber in August timeframe were a major embarrassment and servered as the kind of "I told you so" that when shared with the press in November of this year really helped "un" coveroregon.
David F. Carr
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David F. Carr,
User Rank: Author
3/7/2014 | 3:40:19 PM
Re: Oracle blameless in Oregon health insurance exchange fiasco?
@Gigabob

Was there something about Cover Oregon that made it more complex than other state projects that did incorporate some off-the-shelf software as a starting point?

Also not clear what you're saying about Sheehan: do you believe he was advancing a partisan political agenda? If I'm reading you right, you also say that the project leaders at the state refused to listen to constructive criticism (maybe writing it off as partisan?)
Mr. Gigabob
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Mr. Gigabob,
User Rank: Strategist
3/7/2014 | 11:02:14 AM
Re: Oracle blameless in Oregon health insurance exchange fiasco?
Sheehan's post and focus joins several other from the Repulican side of the aisle that were viewed at the time through the polarizing lense of National Health Care Politics.  If we accept Rep Sheehans perspective it also is a key indication of why Oracle has a responsibility for the mess at Cover Oregon. 

In the actual bidding process there were three vendors - IBM, Oracle and a smaller third party.  After clarification on the bid neither IBM nor the third party felt qualified to execute, and dropped out.  This augurs strongly against the proposition that readily avaialble OTS SW, either opensource, commercial or otherwise could have been used to build CoverOregon.  Oracle moved in, bringing Oracle products and developers and had no plans to leverage open source tools to shorten a time and materials contract or reduce lucrative licensing contracts later.  

Calls by Sheehan to shelve Oracle and other Republicans to heed the audit reports showing the project missing key milestones a year earlier were not seen as constructive criticism by engaged lawmakers seeking the best outcome for Oregon Citizens - but as Republican Obamacare attacks.  I had reservations about this project from the beginning and was familiar with managers reputations inside Oregon IT.  When contacted to interview for a Project Management Role for this effort, I ran for the hills.  In 2011.  It was clear to me at the time that with Federal money behind it, Oregon IT directors driving it and Oracle that this was a Titanic Project - with similar outcome.
Mr. Gigabob
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Mr. Gigabob,
User Rank: Strategist
3/6/2014 | 6:48:58 PM
Re: Oracle blameless in Oregon health insurance exchange fiasco?
That both Oregon's ineffective management under Carolyn Lawson and Oracle - her chosen partner - share blame for this debacle is not for debate.  Assinging singular blame to either party in a marriage of this intimacy is about beating a dead horse.  Oregon sought to establish a new standard and hired what it thought were competent mangers to execute a project they deisgned to dwarf the scale of any previous "Large IT" effort - all of which had previously been challenged to deliver according to plan.  Oregon made several key mistakes - obviously Lawson was the biggest - but working on their own to create not just an insurance applicaton site - but a complicated financial tool designed to navigate the arcane paths of healthcare billing systems, tax policy and often contrasting user needs - all within a very contrained period of time was a major bridge too far.  

IMO the real issue is why major Federal programs like this are even given an option at the state level to proceed on their own - without clear guidelines and milestones to synchronize efforts and make sure systems are interoperable instead of having 50 separate efforts that can vary so widely in scope.
WKash
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WKash,
User Rank: Author
3/6/2014 | 4:38:21 PM
Siding with Uncle Sam
As much trouble as the federal health care exchange experienced, it's growing evident that the majority of states that participated in the federal exchange are probably better off than states like Oregon and Maryland that went their own way and now have big holes to fix -- and not the resources Uncle Sam had.  Oregon's tale also seems to be a case where internal politics and inadequate management (reflected in the decision not to reuse existing applications) would make it hard for any vendor to succeed.

 
jagibbons
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jagibbons,
User Rank: Ninja
3/6/2014 | 12:18:03 PM
Re: Oracle blameless in Oregon health insurance exchange fiasco?
Rarely are folks that blunt and forthcoming about their next job. In my experience, individuals make choices that would help lead to a future opportunity rather than buying a job by granting a contract.

Whether or not the CIO was hoping for a position in Oracle, it's easy to connect the dots and find a conclusion in hindsight, even if it's not the right conclusion. Whether or not she was, every company would benefit from non-hire clauses in contracts just to remove any possibility of that conflict of interest.
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