Thursday, October 09, 2014

Lazarus lives again in Massachusetts, but at what cost?

There was a lot of coverage last year about the glitches and extra costs associated with the federal government's health care exchange website.  Must less was said about the problems faced by Massachusetts in its execution of the state portal.  In fact, Trudy Lieberman at the Columbia Journalism Review wrote an article about the paucity of local coverage of this issue.

Much of the public exposure on the delays and cost overruns has been produced by a local policy think tank, the Pioneer Institute.  It has assiduously outlined flaws in the project management and has provided the press and the public with material that raised serious questions about the competence of the state administration in this arena.

Bruce Mohl at Commonwealth Magazine offers an excellent summary of the issue here.  The Governor's folks are claiming that the costs are one number, but Pioneer folks remind him that it is not right to leave out the additional federal costs associated with the mess-up.  As Mohl writes:

Stergios urged the Patrick administration not to focus just on the state costs associated with the failed website but to also incorporate federal expenses into the mix, just as officials did with cost overruns on the Big Dig.

"The media and public did not divide that important project's costs into 'the state share' and 'the federal share.' The case of the Health Connector should be viewed through the same big picture lens, especially since the Commonwealth could easily have opted to join at little or no cost to the state, or to stick with a somewhat modified version of the original website, which was working well pre-Affordable Care Act," Stergios wrote. 

Mohl's piece is well worth reading in its entirety, from the starting sentence on:

The state's health care exchange website is about to return from the dead, but the cost of resuscitation remains far from clear.


nonlocal MD said...

Well they certainly weren't the only state to do it badly. I am trying to decide what lesson that carries - are state governments incompetent, or is the IT industry a big scam operation, or what? All these failures at the same task must mean something.

Anonymous said...

I think we are the only state that botched things this badly and DID NOT fire anybody. We paid tens of millions so far for a web site that still does not work and hundreds of millions to cover people (who couldn't enroll due to the lack of a working web site) on free Medicaid whether they qualify for it or not. This continues as of today and no one was held responsible.... in fact I think the Connector staff got pay raises recently. Truly astounding given their failures. Governor Patrick is trying to tamp this down so it isn't a billion dollar issue should he try and run for President some day in the future. The Health Connector leaders should have resigned or been fired. They decided to go with CGI and their decision cost us a billion dollars in web site work and free care handed out. Now they are leaning on Optum to bail them out.... I am not sure what the Connector staff even do given all the work is farmed out to third party contractors? The other fact is that the private Medicaid plans (Network Health, Neighborhood... etc) are losing their financial shirts in Massachusetts and if they exit at some point in the future you will see a huge surge in straight Medicaid enrollees which will burden the state, feds and hospitals / providers given how poorly they pay. Not a lot of good choices and the Connector and its leadership have a lot to do with it.