Report Blames Mass. Health Website Troubles On Lack Of Skills, Leadership

In the months after President Obama signed the Affordable Care Act (ACA) in 2010, officials in Massachusetts started planning for a new Health Connector website that would be compatible with the new federal regulations. UMass Medical School, the Massachusetts Health Connector and MassHealth came together to work on the project. They hired a Canadian firm, CGI, to build the site which launched in October 2013, but "was not fully operational," according to a report released Thursday by the technology firm MITRE. Residents who've tried to apply for insurance through the site use words like "disaster."

The MITRE report, which was commissioned by the state, says CGI did not have the expertise to create or maintain the site. Functions were not tested. Data was lost. Tools to fix bugs were not in place. So who from the state should have spotted and corrected these problems? MITRE concludes that it was never clear which of the three state partners was in charge. Gov. Deval Patrick says the shared leadership structure would have been fine if CGI had done its job.

But, Patrick added, "It turns out that this vendor has required and will require a much, much shorter leash. And that’s hard to do by committee."

The lack of clear authority created other problems, according to the report. The website never had a baseline set of requirements. There was no master schedule. Decisions were not explicit and were not communicated clearly. CGI received conflicting instructions and deadlines from the three parties in charge.

Gov. Patrick is adopting some of the several changes suggested by MITRE. He's hired a special assistant — Sarah Iselin -- who will direct site repairs. Iselin has worked on expanding health insurance for the state, for a nonprofit and most recently at Blue Cross Blue Shield, where she has taken a four month leave. Iselin says there are plenty of places to assign blame for what happened with the Connector website.

"It’s both clear that the vendor wasn’t able to deliver the website they were hired to deliver and it’s also clear that the project management was inadequate for the task," Iselin said.

Iselin says those problems will be fixed with the help of Optum, a firm that worked with the federal government to fix HealthCare.gov — which was also built by CGI. Funding for Optum’s one month, $9.8 million contract will come out of money budgeted for CGI. The Optum contract includes 300 people who will help residents with paper and online enrollment.

The Obama administration ultimately canceled its contract with CGI. Gov. Patrick is keeping the contractor, at least for the next few months.

"We still need CGI for the time being at least to help us fix a largely fixable system," Patrick said.

In a statement, CGI says it "looks forward to continuing our work with Optum to accelerate improvement of the Massachusetts Health Connector. We remain determined to help Massachusetts residents get insured by enrolling in health plans via the Connector, and we fully intend to meet our contractual obligations."

CGI has, it points out, designed successful sites in Colorado, Kentucky and California. Those close to the Connector site says Massachusetts is a more complicated system because the state has many more ways that residents can meet Medicaid eligibility requirements.

Gov. Patrick applauded employees who have come up with ways to work around flaws in the CGI site. He said staff at the Connector and MassHealth have worked tirelessly to make sure that roughly 150,000 Massachusetts residents who were on subsidized insurance, or who are trying to get on for the first time, have some kind of coverage. Patrick apologized Thursday to all those who have been frustrated and worried about not being able to get care. Iselin says she’s confident the state will fix the Connector site and the enrollment process as a whole.

"One way or another," Iselin said, "we’ll ensure that folks don’t lose coverage and one way or another we get to our goal of having a world class website."

Iselin plans weekly updates leading up to the next critical federal insurance deadline, March 31. But restoring the public’s confidence may be more difficult than processing the major backlog of insurance applications.

"I’ve put in all this effort and I don’t have insurance and I really don’t know where else to turn" said Dan Ginsburg, who made more than a dozen calls to the Connector in December and January, trying to renew his private health insurance plan.

Ginsburg, who is from Southborough and runs a small software firm, says he bought a family plan on the Connector's old website last year with no problem. He was finally able to renew last month and sent the Connector a check for more than $1,200. It was cashed, but Ginsburg's insurer says they did not get the money and cancelled his plan.

Ginsburg says he supports state and federal efforts to expand health coverage.

"I want to see it work, I really do," Ginsburg said. "But it just seems fundamentally wrong to me that you could be accepting payment for people's insurance and then not providing insurance. That, to me, borders on fraud."

IT experts contacted for this story, say that function — sending payment and enrollment information to an insurer — should be an easy step on the Connector website. We’ll track how quickly it gets fixed.