User-facing components performing well, says project overseer Jeffrey Zients. But questions remain whether the back end will work for insurers.
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The Obama Administration announced over the weekend that it has met its self-imposed deadline of November 30 to make critical repairs to HealthCare.gov, the federal website for individuals to buy health insurance.
Downtime, error messages, and incorrect data dogged the site from the moment it went live on October 1. During some weeks in October, the site was down an estimated 60% of the time, according to the Progress and Performance Report released December 1 by the Department of Health and Human Services (HHS). But HealthCare.gov's performance has improved steadily following a series of congressional hearings; an overhaul of the team of vendors developing the site, whereby Columbia, Md.-based Quality Software Services Inc. was named general contractor; and the installation of Obama go-to performance official Jeff Zients as project overseer.
"The site is now stable and operating at its expected capacity," Zients said in a Sunday morning conference call with reporters. By "expected capacity," Zients was referring to a target of 50,000 users per hour, 800,000 in a given day.
Site fixes and improvements continued up to the November 30 deadline. "More than 50 bug fixes were installed [Saturday] night, many for improvements in the backend of the system," Zients said. In all, contractors working on the site made more than 400 fixes and software improvements since the October 1 launch date, he said.
The troubleshooters installed dedicated hardware to eliminate the bottleneck for the registration database, achieving a fourfold performance improvement, Zients said. The core database now runs on 12 dedicated servers with upgraded storage.
Jeffrey Zients addresses the possible government shutdown earlier this year.
Another significant improvement was to the system's firewall. "The firewall was a constraint on capacity and throughput, so it was upgraded," achieving a five-fold improvement, Zients said.
When HealthCare.gov was launched on October 1, the average time for the system to respond to user input was eight seconds; for the past three weeks, the average response time has been under one second, Zients said. Site errors were occurring 6% of the time in October; as of November 29, errors were occurring 0.75% of the time, he said.
Questions remain, however, about backend components of the site. Are insurers receiving the correct information from consumers for plans they're enrolling in? Is the government providing the correct information about subsidies consumers might be eligible for? And is the government ready to pay those subsidies to the insurers? The New York Times and others reported that Zients' team prioritized improving the citizen-facing portion of the site, deferring repairs and improvements to the backend components.
Karen Ignani, CEO of the trade group America's Health Insurance Plans, acknowledged that "Healthcare.gov and the overall enrollment process continue to improve," but she said the most significant backend issue that still must be addressed is "the ongoing problems with processing 834 enrollment files" -- the forms that give insurance companies basic information about would-be customers.
With most HealthCare.gov insurance plans set to go into effect Jan. 1, 2014, the biggest question will be whether the troubleshooting team can make all needed improvements in time, especially as Zients is moving on in January to become the director of the National Economic Council.
Speaking on NBC's Meet The Press on Sunday morning, Rep. Mike Rogers (R-Mich.) focused on the security of HealthCare.gov. "The security of this site and the private information does not meet even the minimal standards of the private sector, and that concerns me," Rogers said.
"I don't care if you're for it or against it, Republican or Democrat," he continued. "We should not tolerate the sheer level of incompetence securing this site. And remember how much personal information is not only there, but all of the sites that the hub accesses would expose Americans' personal information in a way that is breathtakingly bad."
But Ezekiel Emanuel, a former health policy adviser to President Obama and now a professor at the University of Pennsylvania, called the recent site improvements "good enough progress."
"Clearly, just like Google and Facebook and all the other Internet sites that are constantly tweaking their sites, constantly improving them, this one still has a ways to go," Emanual said. "I, in particular, want the 'shop and compare' [feature] to improve. That's a key area where people can see what's available, what the prices are."
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