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Shows & Panels
Why HealthCare.gov still isn't fixed
Tuesday - 12/3/2013, 11:45am EST
Federal News Radio
If you read the eight-page fix-it report from the Centers for Medicare and Medicaid Services, you could be fooled into thinking, "Gee, job done!" But look carefully and you'll find claims that are hard to verify and others that don't point to a business-grade level of website operation.
In particular, I note that as of Sunday, CMS was claiming 95.1 percent availability. That translates to nearly a day and a half per month of downtime. A CIO responsible for a high-activity commercial site would be canned for that level of performance if it lasted very long. Most strive for the "five nines" level of availability, which translates to five minutes of downtime per year. Ninety-nine percent uptime means 3 1/2 days down per year.
CMS is claiming a 4x "registration throughput" improvement, 3x "database throughout" improvement, and 2x "capacity" increase — together with 5x network throughput improvement. Taking the agency at its word, the bottleneck would therefore be "capacity." Consistent with the weakest-link theory, even with a 10x network throughout increase, users will only see improvement as extensive as the smallest improvement. For a site that was down nearly half the time and slow when it was operating, a 2x limiter on performance doesn't sound like a triumph.
The whole episode calls into question President Barack Obama's belief that the failure of HealthCare.gov's launch was connected to the government's inefficiency at IT procurement. Procurement is a popular canard. Sometimes it really is the problem. But not in this case. The awards to contractors were made in reasonable time using an existing multiple-award vehicle in place at CMS. The technologies used are neither exotic nor out of date as a result of slow procurement. It looks to me like a matter of pure project management, or lack thereof.
CMS cites twice-a-day "standup war room" meetings. It says "the team is operating with private sector velocity and effectiveness" with "clear accountability and decision-making." Well, OK. The report shows things going in the right direction. But it deepens the mystery of what was going on since March 2010 when the Affordable Care Act became law.