Andrew Slavitt – Tesimony on the Healthcare.gov failuresEmbed
Chairman Upton, Ranking Member Waxman, and members of the Committee, good morning.
My name is Andy Slavitt, and I am Group Executive Vice President of Optum, a business unit of UnitedHealth Group. Optum owns Quality Software Services, Inc., or QSSI. QSSI has worked with CMS since 2006 and is one of the contractors working on the online health care marketplaces. I am here today to discuss QSSI’s role in the health insurance marketplace system that was created to support the Patient Protection and Affordable Care Act.
Data Services Hub
Let me begin by addressing our work on the Data Services Hub, a large and complex project that was the subject of much interest in our work for the marketplace prior to the launch.
Simply put, the Data Services Hub is a pipeline that transfers data – routing queries and responses between a given marketplace and various trusted data sources.
Here’s how the Data Services Hub works: A consumer interested in purchasing health
insurance online goes to a health insurance marketplace’s web portal to fill out enrollment forms and select a plan. Certain information the consumer provides to the marketplace, such as citizenship, must be verified. The Data Services Hub directs queries to information sources, such as government databases, that can verify that information, and sends the responses back to the marketplace.
Its function as a technology pipeline means that the Data Services Hub does not determine the accuracy of the queries or the responses it transports. It does not store any data.
Additionally, the Data Services Hub itself does not determine consumer eligibility, nor does it determine which health plans are available in the marketplaces.
QSSI completed code for the Data Services Hub in June 2013. We conducted performance
testing in August and September, as did CMS’s independent tester. There was also an
independent Security Risk Assessment completed by the Mitre Corporation on August 30,
2013. There were no unusual findings and any necessary adjustments were completed. The
Data Services Hub received its authorization for CMS to operate on September 6, 2013.
I can report to you that the Data Services Hub has performed well since the marketplace’s
launch. On October 1, the Data Services Hub successfully processed more than 178,000
transactions. Since then, it has continued to process hundreds of thousands of transactions
daily among the various federal and state marketplaces, trusted data sources, and issuers.
When we have encountered occasional bugs in the Data Services Hub, they have been
discrete issues and we have promptly corrected them. While future issues could arise and
business requirements could change, to my knowledge, the Data Services Hub continues to
Registration Tool – EIDM
In addition to the Data Services Hub, QSSI also developed a registration and access
management tool – called the EIDM – that is used as one part of the registration system that
allows consumers to create and use an account. The EIDM tool has been successfully
deployed previously in two other CMS applications.
Here is the timeline for the EIDM development: QSSI completed the code for the EIDM tool
and conducted performance testing in February and March 2013. There was also an
independent Security Risk Assessment completed by the Mitre Corporation on February 15,
2013. The EIDM tool received its authorization from CMS to operate on March 22, 2013.
We continued to develop and test software to integrate the EIDM tool with the Federal
It is relevant to note that the EIDM tool is only one piece of the federal marketplace’s
registration and access management system, which involves multiple vendors and pieces of
technology. While the EIDM plays an important role in the registration system, tools
developed by other vendors handle critical functions such as the user interface, the e-mail that
is sent to the user to confirm registration, the link that the user clicks on to activate the
account, and the web page the user lands on. All these tools must work together seamlessly
to ensure smooth registration.
After the launch, healthcare.gov was inundated by many more consumers than anticipated.
Many of the critical components developed by these multiple vendors were overwhelmed –
the virtual data center environment, the software, the database system, and the hardware, as
well as our EIDM tool.
It appears that one of the reasons for the high concurrent volume at the registration system
was a late decision requiring consumers to register for an account before they could browse
for insurance products. This may have driven higher simultaneous usage of the registration
system that wouldn’t have occurred if consumers could “window shop” anonymously.
In the days that followed the launch, the QSSI team worked around the clock to enhance the
EIDM tool to meet this unexpected demand. As I understand it, this effort has largely
succeeded. By October 8, even at high levels of registration, the EIDM tool was processing
those volumes at error rates close to zero, and continues to do so. As a result of this work,
the EIDM tool is keeping pace with demand. At CMS's request, we are working with other
vendors to plan for even higher peak levels of activity.
Finally, QSSI was one of several testers used to test the functionality of the federal
marketplace. In our role as tester, we were tasked with identifying errors in code that was
provided to us by others. We reported the results back to CMS and the relevant contractor,
who in turn was responsible for fixing coding errors or making any necessary changes.
We do understand the frustration many people have felt since healthcare.gov was launched.
We have been, and remain, accountable for the performance of our tools and work product.
As I noted, the Data Services Hub has performed well since October 1, and while the EIDM
tool had initial scalability challenges, the system is now keeping up with demand. We are
committed to helping resolve any new challenges that may arise in any way we can.
Thank you for the opportunity to discuss QSSI’s work on the online healthcare marketplaces.
I am happy to answer any questions you may have.
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