MNsure’s latest internal reviews show staff continuing to identify serious problems with the project, and the status of the health exchange appears worse off now than it was weeks ago as Tuesday’s launch approaches.
Since MinnPost began receiving internal documents — which include weekly project status reports, technical documents and risk assessments — in early September, three of seven areas that MNsure staff and vendors are consistently working on have been deemed worse off than before.
The entire project is still “red,” or “at risk,” of going online by Tuesday, and two new work areas are now considered “at risk,” according to Sept. 19 documents. One area was also raised to medium risk, but still with “critical issues” to be resolved.
Successful launch predicted
Asked to comment on progress on fixing the problems since the Sept. 19 reports, officials declined to answer specific questions and instead issued a two-sentence response via email: “We are addressing all issues that need to be addressed for a successful launch on October 1. We are on track to be up on October 1.”
In recent days, MNsure Executive Director April Todd-Malmlov has offered a much cheerier view of the project to lawmakers and MNsure’s governing board than the documents depict. She has said the project will go live on Tuesday with key functional requirements unless a final check finds serious security holes to keep it grounded.
“We are planning to be up on [Oct. 1],” Todd-Malmlov told the board at a meeting on Wednesday. “Things are looking very good. The system is secure.”
Todd-Malmlov has reviewed older versions of the documents with MinnPost in the past and brushed off the issues. She said the “at risk” status is typical for a project of the magnitude and compressed timeframe of Minnesota’s state-based health insurance exchange.
“The entirety of the project scope has always been red — at least one part of it has always been red,” Todd-Malmlov said during an interview last week. “It’s an indicator for us as to where to focus efforts.”
“I think it’s a misnomer to talk about something moving from ‘yellow’ to ‘red’ as getting worse, or for that matter of saying going from ‘yellow’ to ‘green’ is getting better,” MNsure governing board Chairman Brian Beutner said when asked about the shifting statuses on Friday. “All it really is measuring in the project management sense is confidence in the degree of risk.”
MNsure Board Chairman Beutner said the risk levels indicate where time and energy should be spent on a project. He said he was buoyed at the Wednesday meeting with MNsure staff’s plans to have a significant amount of communication between the exchange, the counties and others.
“If something’s ‘red,’ I want to make sure that we’re highlighting that, that we’ve got early warning indicators,” he added. “If something’s ‘green,’ I’m not worried about checking in on a daily or hourly basis because I think it’s supposed to go well …. It’s something that requires attention or requires less attention.”
MNsure staff is divided into groups to work on different pieces of the project, from focusing on small businesses to working on eligibility and enrollment. Different work areas are listed in the internal status reports at different times, and sometimes the reports don’t match up week-to-week.
8 of 12 areas ‘at risk’
Of the seven areas that staff noted consistently from Sept. 5 through Sept. 19, five of seven areas had the worst project status possible. Of the 12 areas staff tracked in the documents MinnPost obtained, eight of 12 had an “at risk” status when staff described the work area.
The newest documents show critical issues with the lack of testing and ability to process appeals. The small-business portion of the exchange also continues to have problems, according to the documents.
There’s no small-business area — called SHOP — test plan or a system to test with, no way to report defects with the system and “an unclear path for moving fixes into code that will be moved … ultimately into production,” according to a Sept. 19 status report.
The exchange’s “finance” workgroup went to “at risk” last week. Functionality is still in the “process of development and [user testing]” and “key system tests have not been verified” between MNsure and certain vendors, according to the documents.
Todd-Malmlov told MinnPost last week that staff is constantly evaluating the project to see what will be ready to go online. A significant amount could have changed day to day since the documents were compiled as exchange employees worked to complete the project.
But, according to the technical report, the exchange implemented a “code freeze” beginning on Tuesday. “NO CHANGES without Command Center approval,” it reads.
It’s unclear exactly what MNsure management would allow through, however.
Some of the key functions the exchange is supposed to perform weren’t available last week, the reports show. User account creation, eligibility determination, tax credit calculation, Tribe and Native American enrollment and unsubsidized qualified health plan purchasing were unavailable in that version of the project.
Some problems fixed
Todd-Malmlov, who reviewed that portion of the document with MinnPost at the Wednesday board meeting, said the newest version had fixed most of those problems. According to the documents, the newer code would only correct the tax credit calculations.
“We’ll review [the newest version] of the code (when it’s ready) to see if the fixes will allow the code to be usable in production,” the status report says, but it doesn’t note when the next version would become available.
MNsure did, though, pass two key federal reviews from the IRS and the Centers for Medicare and Medicaid Services, Todd-Malmlov told the governing board on Wednesday. Those reviews will allow the exchange to connect to the federal data hub, which will provide key information to run the exchange.
Todd-Malmlov said the latest IRS review, which looked at data security, was “very extensive.” Other state officials have said MNsure’s IT security systems will be a model for state government.
The exchange leader also showed a one-page “go-live” plan to the board on Wednesday that outlines daily and weekly meetings and calls with stakeholders ranging from the counties and the carriers to the federal government.