Open Group Presentation final
- 1. From Build to Run at the Colorado Health Insurance Marketplace July 21, 2014 Proteus Duxbury, CTO Connect for Health Colorado
- 2. 2 …unknown
- 3. 3 Helping to make Coloradans smile
- 4. 4 4 12 What is Connect for Health Colorado? An open, competitive marketplace for individuals and small employers to: • Shop health plan features • Compare information regarding cost and quality • Determine eligibility for and access financial assistance • Support network access, including service center, health coverage guides and brokers • Enroll in a health plan Shop for Plans
- 5. 5 Choice – Individual Marketplace 150 Health Plans 22 Dental Plans
- 6. 6 Choice – Small Business Marketplace 92 Health Plans 45 Dental Plans
- 7. 7 We have enrolled 139,000 consumers
- 8. 8 We have a varied and mixed pool of enrollees
- 9. 9 Our marketplace users are very active
- 10. 10 Systems are performing well under load 0 500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000 3,500,000 4,000,000 1-Oct 16-Oct 31-Oct 15-Nov 30-Nov 15-Dec 30-Dec 14-Jan 29-Jan 13-Feb 28-Feb 15-Mar 30-Mar 14-Apr Volume Median M-F
- 12. 12 Strong leadership has been critical to our success • Leadership & team o Shared vision o Empowered to make decisions o Start-up culture o Skilled and highly dedicated team • Flexible vendor o Agile with rapidly changing regulatory requirements o Committed to achieving success o Strong contract and definition of requirements • COTS solution o Minimal customization and custom development o Scope control o Leading HIX suite o Best of breed around the edges o Highly resilient and available architecture o Secure Vendor Solution Team LEADERSHIP
- 13. 13 We have a 3 year roadmap to move from build to run 2015 – THEN “STABALIZE” Implement the ‘run’ strategy. Stabilize the technology in production and reduce overall technology spend in line with sustainability targets. Moving to a variable IT cost where possible. 2016 – FINALLY “REACH THE SUMMIT” Business as usual technology operations. Predictable ‘run’ environment with ability to deliver on new project requests efficiently. 2014 – FIRST “BUILD” Complete the implementation of the marketplace and eligibility system builds as planned. Develop ‘run’ strategy. Base Camp Start • All ITIL processes fully deployed • Continuous improvement program in place • Metric driven IT organization • Predictable IT cost base • Innovation • Full sourcing strategy benefits realization • Ongoing innovation and enhancement • ITIL implemented • Architecture enhancements deployed • Key contracts renegotiated, sourcing re- balanced • Operational cost base established with variability where possible • API implemented • Consulting support significantly reduced • 1.x marketplace functionality deployed • Release 2.0 marketplace functionality deployed • Shared Eligibility System deployed • IT strategy developed • Sourcing strategy / new SLAs documented • C4 IT Team fully resourced • Architecture review and roadmap • Capacity planning 13
- 14. 14 Why architecture is important!
- 15. 15 Why are we building an architecture roadmap? • Reduce M&O expense • Consolidate architecture and gain efficiencies • Continue to meet key SLAs • Operationalize IT • Stabilize foundations as a platform for future growth • Align technology investments with business goals • Motivate new team
- 16. 16 A quick poll – setting and documenting goals • Group 1 was asked to simply think about the business-related goals they hoped to accomplish • Group 2 were asked to write their goals • Group 3 was also asked to write action commitments • Group 4 had to both write goals and action commitments and also share these commitments with a friend. • Group 5 did all that and sent a weekly progress report to a friend. 43% 64% 76% Psychology professor Dr. Gail Matthews
- 17. 17 Do you ever feel like this?
- 18. 18 Challenges in building out the roadmap • Budget is a constraint • There are many federal requirements we must meet • Multiple partner engagement • Multi-vendor environment • ‘Startup in a fishbowl’ • Delivering while planning
- 19. NAME OF | High level roadmap approach
- 20. 20 • Loosely coupled Technology Agnostic Design (TAD) • Enterprise COTS solutions over custom developed solutions • Best of breed where strategic • Pay for compute • Data entered once and shared across systems (single source of truth) • Use State data sources for verification • Low M&O impact architecture • ROI driven architecture Key C4 Architectural Principles 20
- 21. 21 We started by mapping our business capabilities Business capabilities map L2Key: L1Business Capability Map 7. Conduct Core Operations Enrollme nt 7.2 ManageBillin g Syste m Sharin g 7.7 ManageGovernment ProgramEncounte rs 7.0 Business Management and Shared Services 7.3 Manage IT Services 7.4 Manage Financial Operations 7.5 Manage Procurement 7.7 Manage Compliance, Legal, Regulatory 7.9 Manage 7.2 Manage Enterprise 1. Develop Product 1.1 ImplementProduct Strategy 1.2 DesignProducts 1.3 Manage Ancillary Services Actuari alServic es Member 2. Plan Management 2.1 Establish Issuer and Plan Details 2.2 Monitor Plans 2.3 Manage Plan Management Rules 5. Communications 5.1 Manage Outreach 5.3 Manage Notifications 5.2 Manage Communication Rules 4. Customer Service and Account Management 4.1 Manage Customer Support 4.2 Manage Enrollee Survey 4.4 Manage Rules 4.3 Manage Broker / Navigator Relationship 1. Enrollment and Eligibility 1.1 Manage Individual Eligibility & Enrollment 1.2 Manage Individual Responsibility Exemption 1.3 Manage SHOP Employer Eligibility and Enrollment 1.4 Manage SHOP Employee Eligibility& Enrollment 3. Financial Management 3.1 Transaction Processing 3.2 Risk Management 3.4 Rules Management 3.3 Payment Monitoring 3.5 Reporting 6. Oversight 6.1 Governance and Management Support 6.2 Human Resource Management 6.3 Assets Management 6.4 Knowledge and Information Management 7.6 Manage Vendors 1.5 Manage Appeals 7.1 Manage Channel Interfaces 7.8 Manage Internal Audit 7.9 Manage Public Relations 7.10 Manage Continuous Quality
- 22. 22 … and aligned our application portfolio against them 22
- 23. 23 Our roadmap has a series of transitional states
- 24. 24 Our roadmap has a series of transitional states …
- 25. 25
- 26. 26 Key elements of the roadmap • Release 2 • Cloud • Mobile • APIs • Decision support • Integration • Architecture enhancements • Data quality / governance • New products Need Help?
- 27. 27 Some lessons learned along the way • Without a burning platform the chance of failure is high • Speak a language the business can understand … Don’t use the ‘A’ word • Continually demonstrate ROI • Business design is critical • Be tactical and strategic • Don’t be afraid to make tough decisions … and stick to them
- 28. 28 Thank you! Any questions? Proteus Duxbury CTO Connect for Health Colorado E-mail: [email protected]