By Jueseppi B.
When a White House faces a political crisis, one of the first decisions presidential aides must make is when to get its side of the story out. Too early, and the administration comes off as evasive or dislocated from the issue. Too late, and the narrative becomes too ingrained in the American psyche to change. In the two months since the Affordable Care Act’s exchanges launched, the Obama White House has struggled to balance the two priorities, but not any longer.
“While we strive to innovate and improve our outreach and systems for reaching consumers,” representatives from the Centers for Medicare & Medicaid Services wrote in a report released early Sunday, “we believe we have met the goal of having a system that will work smoothly for the vast majority of users.”
After weeks of denying interviews and doling out small minute bites of information, the White House is pulling back the curtain to give reporters their take on how the Obamacare website failed so spectacularly — and most importantly for them, the steps they are taking to fix it. The administration is now cooperating on the spate of “tick-tocks” and profiles detailing previously undisclosed efforts to fix the law. The New York Times was given access to the healthcare.gov “war room.” The Times and the Associated Press took “strolls” with Chief of Staff Denis McDonough around the South Lawn of the White House.
“Bottom line: Healthcare.gov on December 1 is night and day from where it was on October 1,” said Jeff Zients, the former director of the Office of Management and Budget and future Obama economic aide, who was brought in to manage the salvage of the website, on a conference call with reporters.
The administration’s push comes as its “end of November” deadline for fixing the troubled website expired, and the results are mixed. According to CMS, which runs the website, error rates and response times have been significantly reduced, while capacity has been increased to handle 50,000 concurrent visitors and 800,000 visitors per day. More than 400 software fixes have been made as “private sector velocity” in the parlance of the administration.
But it is still a work in progress, even as the administration claims they’ve met their goal of having the site work for 80% of users. Core functionality of the site still needs to be built in the coming months, and it is far from a completely stable platform. The site still suffers from long periods of planned downtime as engineers install and test software patches, and hundreds of fixes still need to be made.
On Friday, America’s Health Insurance Plans (AHIP) President and CEO Karen Ignagni released a statement saying that while the website is getting better, insurers still have concerns.
“Until the enrollment process is working from end-to-end, many consumers will not be able to enroll in coverage,” she said. “In addition to fixing the technical problems with healthcare.gov, the significant ‘back-end’ issues must also be resolved to ensure that coverage can begin on January 1, 2014. In particular, the ongoing problems with processing ’834′ enrollment files need to be fixed.”
Indeed, as the deadline approached, the administration appeared to dial back on its pledge, explaining that for some people, the website will never work: those who still suffer technical issues, those who aren’t sufficiently financially or technically literate to navigate the site alone, and those with complicated personal situations that will need one-on-one assistance over the phone or in person.
As frustrated Democrats turn their sights on the law, and Republicans gleefully attack the administration’s management failures, the fact that they can’t point to a complete success will undoubtedly complicate the White House’s political task in the weeks and months ahead. “That will be an annoyance,” a senior White House official told TIME last month, who added it will be a “distraction.” “I can just tell you what Twitter will say on December 1,” the official added. “Some person will have a problem and will be on the Today show the next day. That’s going to happen. And that is not a problem you can manage for.”
Thank you TIME.
Here’s the full CMS report on the website fixes:
HealthCare.gov Progress and Performance Report
Sunday, December 01, 2013
Progress and Performance Report
Table of Contents
Real Time Monitoring …………….4
Summary and Conclusion…8
In mid-October, the Obama administration conducted an assessment of the site HealthCare.gov. The assessment was conducted by experts from across government and private sector. The team identified the problems and necessary fixes and determined that HealthCare.gov was fixable, but only with significant changes to the management approach, and a relentless focus on execution. This report details the substantial progress that has been made to improve and stabilize HealthCare.gov, including hundreds of software fixes and numerous hardware upgrades, so that the system runs smoothly for the vast majority of users.
The status of HealthCare.gov in October was marked by an unacceptable user experience. Consumers were experiencing slow response times and frequent, inexplicable error messages. The website experienced frequent outages. For some weeks in the month of October, the site was down an estimated 60 percent of the time. The assessment determined the root causes for these site flaws to be hundreds of software bugs, insufficient hardware and infrastructure. The system monitoring and response mechanisms were not sufficient for identifying issues or bugs or responding to them in real time. Inadequate management oversight and coordination among technical teams prevented real-time decision making and efficient responses to address the issues with the site.
Improving the user experience for HealthCare.gov required deeper real-time analysis to the system, additional technical expertise, and a strong management structure to drive the prioritization and metric-driven execution of fixes. The Center for Medicare and Medicaid Services (CMS) appointed QSSI as the General Contractor and Systems Integrator. QSSI, with their deep project management expertise, coordinates all activity with CMS and other contractors. With one central command structure and “War Room” meetings of all key parties held twice a day for real-time, data-based decision making, the team has been able to implement high-performance management practices and drive through a priority set of fixes.
The newly installed technical monitoring instruments have allowed for constant real-time analysis of site performance. With this new data and management structure the team has the capacity to rapidly respond to any incidents and to better understand root causes.
Over the last five weeks, substantial progress has been made improving HealthCare.gov and getting the system to where it needs to be:
- Hundreds of software fixes, hardware upgrades and continuous monitoring have measurably improved the consumer experience
- Site capacity is stable at its intended level
- Operating metrics are greatly improved, and activity levels demonstrate the site is working for consumers
While there is more work to be done, the team is operating with private sector velocity and effectiveness, and will continue their work to improve and enhance the website in the weeks and months ahead. The following charts provide data on the systems enhancements that have been executed, and the resulting improvements in the site’s key operating metrics over the last several weeks.
As the metrics detailed in this report reveal, dramatic progress has been made on improving HealthCare.gov. There is more work to be done to continue to improve and enhance the website and continue to improve the consumer experience in the weeks and months ahead. The new management system and instrumentation have helped improve site stability, lower the error rating below 1%, increase capacity to allow 50,000 concurrent users to simultaneously use the site and will help drive continuous improvement on the site. While we strive to innovate and improve our outreach and systems for reaching consumers, we believe we have met the goal of having a system that will work smoothly for the vast majority of users.
Read The Complete Report: HealthCare.gov Progress Report
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