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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Report Identifies Reasons For Health Exchange Problems

An independent review of the troubled roll out of the state's health care exchange concludes that a combination of factors is responsible for many of the problems at Vermont Health Connect.

The report says the federal government, the Shumlin Administration and the major contractor of the project all contributed to the situation.

Gov. Peter Shumlin called for the independent review after the state’s health care exchange encountered numerous technical problems last fall. The report was done by the firm Berry, Dunn, MacNeil and Parker of Portland, Maine.

The review says an accelerated federal timeline for all state exchanges to go on-line contributed to many problems.

In Vermont, this factor was exacerbated when an original contract to set up the exchange with Oracle fell through, giving the state even less time to complete the project. Eventually, the state contracted with the Canadian firm CGI to design the exchange.

"The schedule of this project was the biggest risk we faced throughout the entire implementation." Health Access Commissioner Mark Larson

Mark Larson is the commissioner of the Department of Vermont Health Access. He concurs with this analysis.

“The schedule of this project was the biggest risk we faced throughout the entire implementation,” said Larson. “And I think that the report today really emphasizes that as a key finding.”

The report also concludes that “CGI created a project team of 180 people who had little to no experience working together prior to this project.” 

Larson says the problems with CGI were not limited to just Vermont.

“That’s consistent with the experience in other states where contractors came in, they brought in new teams that again in a very short time frame had to learn to work together to figure out the work that they were doing,” said Larson.

The report also states that the state and its software vendors “had never completed a software development project of this magnitude and did not fully understand the Affordable Care Act.”  Larson also agrees with this conclusion.

“This building exchanges was a new thing not just in Vermont but across the country,” said Larson. “And they are very complicated because we are trying to connect pieces of a very fragmented health care system.”

Darcie Johnston is the director of Vermonters for Health Care Freedom, a group that opposes the implementation of a single payer system in Vermont.  Johnston says the report should serve as a clear warning for lawmakers in the future.

“Government shouldn’t be taking on big projects like this with deadlines that are not movable but risks the public, and in this case it risked a lot of people’s health care,” said Johnston. “And it certainly doesn’t bode well for going to the next step. It’s not a core competency of government, and it shouldn’t be and there’s a reason why.”

The report also encourages the state to establish clear expectations for individual components of this project and to systematically evaluate all functions of the exchange.

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