A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Meet the New Boss. (NOT the same as the old boss)

Meet the New Boss. (NOT the same as the old boss)

February 7, 2014

Between Governor Patrick’s press conference this morning (press release; and in-depth report from the Springfield Republican) and the Health Connector Board meeting this afternoon (Connector meeting presentation (pdf)) , today has been a busy day for discussing the key challenge of Affordable Care Act (ACA) implementation in Massachusetts – namely, how to fix the MassHealth & Health Connector’s flawed website and underlying IT system. Our full report is below:

Governor Patrick was emphatic about the goal of keeping everyone in coverage: “Those who have coverage will not lose it,” he said, “and those who are seeking coverage will get it…. We’re not going to let anyone go without insurance. It’s not going to happen. We have an obligation that is an obligation in law, and we have a moral obligation and a commitment to doing so.”

In late January, the Health Connector – in consultation with federal officials at the Centers for Medicare and Medicaid Services (CMS) – hired the non-profit technology firm MITRE to complete an assessment of the existing IT system.  The MITRE report (pdf), submitted on Tuesday, cites the IT vendor’s (CGI) lack of sufficient resources and poor project management and communications structures as major drivers of the deficient IT system.  The report also brings to light the lack of unified vision among the Commonwealth’s HIX (Health Insurance Exchange) project team, including EOHHS/MassHealth, the Health Connector and UMass Medical School, resulting in project oversight challenges.

MITRE suggests three main options to move the HIX system forward:

  • Sever the contract with CGI and work with a new vendor to start over building a new system
  • Work with a new vendor to continue incrementally improving the current system
  • Break the current system down into distinct technical segments and re-engineer each segment as to complete the system with a combination of CGI and new vendors

In response to these recommendations, Governor Patrick appointed Sarah Iselin to oversee efforts to repair the website and IT system.  Iselin, who is taking a four-month leave of absence from her role as chief strategy officer at Blue Cross Blue Shield of Massachusetts, will report directly to the Governor and act at the point person for the project. She committed to holding weekly briefings on the project’s progress.

Connector Board 2-6-14 Next Steps

NECN has a good summary of today’s news, including comments by Health Care For All Executive Director Amy Whitcomb Slemmer. Iselin was a guest today on WBUR’s “Radio Boston” program, and we think this 10-minute interview is the best summary of where we are and where we are going. Click below to listen:


Although Governor Patrick has contemplated cutting ties with CGI, the Commonwealth will continue to work with the vendor for now.  The Commonwealth has only paid CGI about $15 million of the nearly $69 million contract, due to the vendor’s poor performance thus far.  In addition, the Connector Board voted to approve a work order with the technology firm Optum/QSSI, the same company that helped fix the federal healthcare.gov marketplace website.  The current work order lasts through April 30, 2014 and caps expenditures in the first 30 days at $9.8 million (see this Connector memo (pdf) on their role).  Optum plans to bring on 300 temporary staff to help with the coverage workarounds and provide customer service support.  Health Connector leadership confirmed that all funds expended for the contracts with CGI and Optum will come out of federal grant funding.

The Governor, HHS Secretary Polanowicz, Iselin and other state officials are meeting with top federal officials at CMS tomorrow to discuss options to ensure people maintain and secure coverage and request additional state flexibility, including the possibility of extending coverage beyond the end of open enrollment on March 31st.

Today’s Connector Board discussion included a mix of questions and comments about the project management structure, how the contract with Optum will work, and how to ensure those with medical needs get covered quickly. The Connector Board will meet for their regularly scheduled meeting next Thursday, February 13th at 9:00am at 1 Ashburton Place, 21st floor.

-Suzanne Curry