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State Health Insurance Exchanges Still Sick
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David F. Carr
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David F. Carr,
User Rank: Author
3/21/2014 | 1:46:25 PM
Re: Lessons learned
The Oregon story is also about trying to "save money" by not hiring a system integrator. They've paid for that decision in so many other ways.
WKash
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WKash,
User Rank: Author
3/21/2014 | 1:10:01 PM
Re: Lessons learned
David, you're probably right about Mass.  Interesting to note how Oregon Gov John Kitzhaber fired the head of the state's online healthcare exchange, and according to a report today in the Washington Post, the state had to hire 500 employees to process 157,000 applications by hand.
David F. Carr
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David F. Carr,
User Rank: Author
3/21/2014 | 12:26:21 PM
Re: Lessons learned
In terms of underestimating the challenge, I have to wonder if the Massachusetts folks also thought the project was no big deal because they'd already done it before.
WKash
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WKash,
User Rank: Author
3/20/2014 | 7:11:37 PM
Lessons learned
David, I think you hit on some good reasons why so many states failed here:  The Feds left the door open to the states to do as they saw fit, but the states were ill prepared to take on the kind of projects these exchanges ultimately became.  That Massachusetts, the state that should have had the most experience, and usually has a good IT record, failed to deliver here also suggests the complexity of these sites -- as you say, they are far more than just web sites.  One would have thought experienced hands could have seen that coming.

The bigger failure in a way is that so much duplicative effort went into buiding these sites. I think you're right, the fact that politicians got to spread a lot of money must have seemed attractive at first.  But it looks like they mostly threw the money down the drain.
Alison_Diana
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Alison_Diana,
User Rank: Author
3/20/2014 | 2:29:49 PM
No Best Practices
In most cases there seemed little use of best practices, for whatever reason. I'm sure, over time, universities and agencies will dissect these rollouts and discover many places where communication broke down, planning was poor, goals misstated, and testing undone, among other mistakes. 


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