HealthCare.gov -- more agile, please
- By Adam Mazmanian
- Apr 21, 2014
HealthCare.gov is officially agile. Contractors who work on design and development of the site must do so using an iterative, agile methodology, according to contracting documents published on April 17.
The Centers for Medicare and Medicaid Services released a draft statement of work on the Federal Business Opportunities website as part of a "sources sought" posting designed to attract small businesses to work as subcontractors on the site. The document contains interesting details about how HealthCare.gov contractors are expected to do business, and it points to what CMS will be looking for when the time comes to review candidates for the prime contracting slot that is set to be awarded in January 2015.
Accenture is currently the prime contractor charged with building and maintaining the e-commerce and data verification system that connects individuals seeking insurance with carriers who are marketing plans, and with the necessary tax information to determine subsidies. But Accenture's $91 million one-year deal is set to expire next January. The short-term deal was made after repeated operational failures at HealthCare.gov soured officials on original contractor CGI Federal. While there’s no indication that Accenture will not be a leading candidate to renew, there are bound to be other contractors interested in the prime slot on HealthCare.gov.
CMS has clearly taken some of the lessons of the botched October 2013 launch to heart. The new statement of work specifies that the contractor will use "an iterative agile methodology to system development that provides the best opportunity to build and test software functionality."
Many of the problems with HealthCare.gov were linked to a compressed testing schedule that gave developers little time to identify and repair problems with the highly complex website. The draft calls for the use of open-source software and open application programming interfaces, and specifies continuing the shift from hosting HealthCare.gov on virtual machines to operating on dedicated physical hardware. And one area that was particularly nettlesome for developers -- automating the process by which enrollment forms called 834s are filed with insurance carriers -- is explicitly noted in the requirements.
In addition to running the front-end shopping portal of HealthCare.gov, the contractor is charged with operating the Small Business Health Options Program and maintaining the financial platform, which at last check was still under construction. The urgency in delivering the financial management piece of HealthCare.gov was cited in December 2013 as a reason to move the contract from CGI Federal to Accenture without a full bidding process.
It's not clear how much of that system is online and how much is being handled using workarounds. But when complete, the financial management system is designed to calculate subsidies for individuals seeking coverage and make payments on their behalf to insurance carriers. The system will also calculate payments to carriers that are exposed to more risk than expected.
The documents also give a sense of the scope of the operations required to maintain HealthCare.gov. An advisory to small businesses says the project employs the equivalent of 400 to 500 full-time employees.
Note: This article was updated on April 21 to clarify the context of the new contracting documents.