Building On Our Progress and Moving Forward: Three Initial Steps

By: Kathleen Sebelius, Secretary of Health and Human Services
Posted December 11, 2013

As more Americans give HealthCare.gov a second look, they are finding that the consumer experience is night and day compared to what it was back in October.  While more work remains, HealthCare.gov is working smoothly for the vast majority of users. As a result of hundreds of software fixes and hardware upgrades – along with countless hours of hard-work – the steps we’ve taken have put us on a path for millions of Americans to finally obtain affordable health coverage.

Yet, the fact remains: The launch of HealthCare.gov was flawed and simply unacceptable.

As we continue our relentless efforts to enhance Healthcare.gov – and as we continue to adapt and improve based on the feedback we are getting from customers and issuers –we must take concrete action to prevent these problems in the future.

I believe strongly in the need for accountability, and in the importance of being good stewards of taxpayer dollars.

So today, I am announcing a series of initial steps in the process of better understanding the structural and managerial policies that led to the flawed launch of HealthCare.gov.

These actions will also focus on our work with contractors.  This is critical, because HHS is the third largest federal contracting agency, and CMS alone spent $5.3 billion in 2013 on contracting engagements.  We must take steps to ensure that our contractors are well managed, and that they fulfill their commitments and provide good services and products for our tax dollars.

We will begin with three things:

First, I have asked our Inspector General, Dan Levinson, to review the development of HealthCare.gov. We need a thorough review of the contractor performance and program management structure that resulted in the flawed launch of the website.  I am asking the Inspector General to review the acquisition process, overall program management, and contractor performance and payment issues related to the development and management of the HealthCare.gov website.

We will take action to address the Inspector General’s findings.

Second, I have asked CMS Administrator Marilyn Tavenner to create a new position and appoint a CMS Chief Risk Officer, who will focus on mitigating risk across CMS’s programs.  This will be a full time, permanent position.  The Chief Risk Officer will work across CMS to asses risk management practices associated with major agency initiatives.  This individual will lead efforts to prepare mitigation strategies to minimize those risks, and will develop metrics to measure the effectiveness of those strategies.

The Chief Risk Officer’s first assignment will be to review risk management practices when it comes to IT acquisition and contracting, starting with identifying the risk factors that impeded the successful launch of the HealthCare.gov website.  I will ask this individual to report back to me in 60 days with recommendations for strategies to mitigate risks in future large-scale, CMS contracting and IT acquisition projects.

Third, we will update and expand CMS employee training on best practices for contractor and procurement management, rules and procedures.  We will expand the scope and content of employee training to ensure that all CMS employees are getting the most extensive and up to date guidance — on a regular basis — for managing projects undertaken through contractors, including best practices for internal communications and processes.

We anticipate that successful risk prevention and mitigation strategies, as well as training updates, will be shared across all HHS agencies.

The steps I am announcing today build on reforms we have already made that have led to significant improvements to the website.  First, in October, we brought on Jeff Zients and a team of experts to manage the day-to-day operations of the website, and we appointed QSSI as the General Contractor and Systems Integrator. CMS also recently changed the day-to-day management of HealthCare.gov.  

While there is still more work to do, HealthCare.Gov is working faster, it’s responding quicker, and we are able to handle larger volumes of concurrent users.

As we continue to build on this progress and take action to prevent these problems from happening again, our top priority will remain the same: making sure that every eligible American who wants to obtain the security of affordable health coverage will have the opportunity to do so.