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McKinsey CMS HealthCare.gov review

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ed Team iscussion document

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Red Team overview, objectives, and approach

 

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1 The Red Team is: 1•

An independent team c harged with pressure t es esting ting existing traj traje ectory o f the federal marketplaces

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Not a backwards looking effort o r aud audiit

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Objectives

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Develop Deve lop a picture o f the planned consumer experience planned over the fi rst year

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Identify consumer paths; review and modify mod ify vignett vignettes es

Identify risks and threats threats to that picture

Define stages of of the journe journey y and risks ris ks to each stag stage e

Identify current and poss Identify possiibl ble e addition add itional al ri sk mit mitii gat ion options op tions

Identify mitigat Identify mitigation ion steps taken take n and other other opt ptions ions to consider consi der

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Pre decisionallnfonnation

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o f the Red Team sources o f insight  

 

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i • Reviewed 20 200+ 0+ doc ume uments nts and artifacts artifacts,, including •

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operational designs and reports reports,, implementation plans, workload forecasts, contract-rel at ated ed documents, and management repor rep ortts and schedules sch edules

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I • Interviewed

4 0 people across 6 CMS/HHS Office Offices, s, Centers, Cent ers, and FFRDC and an d Federal Federal partner agencies

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Participated in select meeti m eetings ngs and working sessions sessions,, incl uding weekly operat inclu operatio ions ns meetings and OI S working sess1ons

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plementin plementi ng the health hea lth i ~ s u r a n c e mark marketplac etplaces es is a · cha llen lleng ge_ .i.n magnitude and com plexity   . . . _  ~ · · . 

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Example Exampl e influence rs and partner agencies



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Interacting, aligning, ali gning, and integrating multiple very large organizations wit wi t h potentially di fferen fferentt definitions o f success

Buyers and sellers ·

Federally facilitated marketplac marketplace e

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State partnersh ip partnershi marketplaces

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Infrastructure

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Launching at scale from day one in all 50 states

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Supporting a compl ex and flexible state marketplace and partnership model

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o f this ty pe i deally have have a e q u e n ~ a l plan planning ning_ _ desig design n, - · im p lementation process w i t h s ig ni niff icant testing testin g and a nd revision P r o g r a ~ s

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imiieci n i : J ~ i O : . l end testing. \ Testing will I continue to be

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Design Desi gn

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· Characteristics of this progra program m

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Current Cu rrent s ituation:

Evol ving requirements • Clear arti articulation of requirements & success metrics • Evolving • Multi Multiple definitions of su success ccess • Minimized dependency on th third ird parties Significant ficant dependency on external externa l parties/ Sequential Seq uential req requirements, uirements, design, build, and testing • Signi contractors con tractors • Iteration and and revision between phases • Parallel "s "stackin tacking" g" of all phases • End-to-end integ integrated rated operat operatiions and IT testing • Insuffic Insufficient ient time and scope of end end-to-e -to-end nd testing • Lim Limiited init initiial launch • Launc Launch h at full volume

 

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CMS has been working to mitigate challenges from

resultingl Informatio program characteristics Confidential and Propri etary - Pre decisiona n

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