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C2170-010 exam Dumps Source : IBM Curam V6.0.4 Application Development

Test Code : C2170-010
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: 77 existent Questions

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IBM IBM Curam V6.0.4 Application

WorkCoverSA Develops fresh systems to assist Employers and Injured workers with the aid of IBM and Cúram utility | killexams.com existent Questions and Pass4sure dumps

HERNDON, Va.--(company WIRE)--Cúram application and IBM (NYSE: IBM) announced nowadays the a success implementation of a number of utility solutions for WorkCoverSA to support their company. WorkCover selected IBM global company functions to set in force the Cúram for employees' Compensation solution, a finished and confirmed claims management solution that manages and automates the finished claim lifecycle from injury to influence, as fragment of a finished modernisation of their IT programs.

WorkCover administers the staff’ Rehabilitation and Compensation Scheme in South Australia on behalf of about 50,000 registered employers and 430,000 personnel. WorkCover collects and manages levies for employers whereas their claims agent control about 20,000 fresh claims and procedure approximately AUD500 million worth of claims payments each 12 months. After finding their customised legacy software difficult and elevated priced to retain, it was discrete they vital a fresh enterprise IT infrastructure that become strong and scalable.

right through the three yr task IBM labored with WorkCover to combine the Cúram for workers’ Compensation reply with IBM Tivoli entry manager for e-enterprise and IBM DB2 regularly occurring Database Workgroup Server, operating on IBM WebSphere software Server. The flexible, solution makes it possible for WorkCover to control claims greater correctly, ensuring superior transparency and consistency in determination making. This improved consistency is driven with the aid of numerous automated calculations and approaches, prior to now performed manually through case managers. in addition, the authority can now respond extra with ease to alterations in law and enterprise priorities with the aid of incorporating them into the Cúram solution, giving it stronger handle over its scheme.

Yvonne Deally, CIO, WorkCover, observed, “Our legacy systems had been more and more customised to the factor they were not efficient to preserve. The Cúram reply applied with the aid of IBM permits their supplier to reply to industry or legislative alternate a whole lot greater conveniently, whereas additionally offering better case administration transparency.”

“This has been one of the most wide IBM implementations of Cúram on earth,” referred to Michael Kinnane, Adelaide utility functions leader, IBM global enterprise services. “IBM integrated Cúram with Tivoli entry manager and mixed Cúram and Tivoli with WebSphere and the DB2 server on a windows platform. they are delighted they now gain labored with Cúram application to support WorkCover build a brand fresh platform that reduces the complexity of again-office techniques, enabling the company to boost its focal point on case management and client provider.”

according to Deally, IBM became instrumental in offering the answer. “IBM had both the abilities and proven song listing to manage and carry what become a complex, three-year challenge efficiently, which protected transferring more than 650 million statistics of client related records stretching returned over two decades. They had been exceptionally impressed through dedication displayed by means of the IBM group to WorkCover and to the success of this task.”

“Cúram utility become joyous to assist WorkCover facilitate most efficient practices for rehabilitation and return to work and to execute sure extra consistent option making and claims management,” referred to Ernie Connon, president, Cúram utility. "Working with IBM, their Strategic expertise associate, they developed an commercial enterprise solution that enabled more desirable transparency and greater constant determination making, focusing on their superior desires of valuable rehabilitation, compensation and return to work.”

About WorkCoverSA

For extra information on WorkCoverSA, please consult with: http://www.workcover.com

About IBM

For greater guidance on IBM, please discuss with: http://www.ibm.com/au

About Cúram software

Cúram utility is the leading issuer of Social commercial enterprise administration (SEM) utility solutions, delivering foremost-in-category purposes for social corporations globally together with, health and human functions, workforce features, and social safety organizations. the usage of the Cúram company utility Suite groups can immediately gleam the merits of customer-centric industry approaches and an effects-driven built-in carrier delivery model. The Cúram industry utility Suite, underpinned by using the Cúram industry Framework, combines the benefits of commercial off-the-shelf (COTS) utility, an enterprise platform and repair-oriented structure with the company and technical flexibility required to allow businesses to implement solutions to fulfill their strategic goals. Cúram software is headquartered in Dublin, eire with workplaces sum through North america, Europe, Australia, and India. For extra suggestions, talk over with www.curamsoftware.com.

Cúram is a registered trademark of Cúram software Ltd. sum Cúram items and repair names are logos and property of Cúram utility Ltd. sum Rights Reserved. Copyright (C) 2011 Cúram utility Ltd.

For extra information about Cúram application, please discuss with: www.curamsoftware.com


IBM application Blamed for afflicted State health Exchanges | killexams.com existent Questions and Pass4sure dumps

application from IBM has been singled out for technical problems hurting both the Maryland and Minnesota on-line fitness exchanges. officials from each states gain blamed IBM’s Cúram, used to examine buyers' eligibility for coverage, for a number of performance concerns, together with dropping client functions.

With the March 31 deadline for open enrollment epoch speedy coming near, state officials gain upped their rhetoric. remaining week, the Maryland fitness Connection stated Cúram and its "serious utility defects." previously, the state blamed a squabble between two basic contractors because the supply for the change’s a large number of bugs.

final month, in a December missive to IBM CEO Virginia Rometty, Minnesota Gov. imprint Dayton distinctive 21 complications MNsure encountered with Cúram, including functions stuck in pending status, as well as inadequate documentation and replica functions.

The continued technical challenges skilled by means of Maryland and Minnesota underscore not most effective the talents weak spot of the application chosen to execute the job, however the problem of structure a web fitness change, even at a state stage, in a comparatively brief amount of time. like other state exchanges, MNsure and Maryland health Connection must weave collectively inner most coverage and federal executive methods to examine buyer eligibility for Medicaid and supply amend coverage classes. Add to this the challenge of working with diverse contractors and the time lost resolving contractor conflicts versus fixing alternate bugs--as was the case with Maryland and a number of other state exchanges—and latest difficulties are more comprehensible, albeit of diminutive consolation to patrons.

Responding to Maryland’s claims, IBM spokesman Clint Roswell referred to that the trade is enhancing and that IBM continues to be working with the contractors on the site. “based on their newest statistics on the alternate's efficiency, they are seeing greater than 95% of patrons entering the web page now having a auspicious event," Mr. Roswell stated in an e mail to CIO Journal. IBM began providing the software when it acquired Dublin, eire-based mostly Cúram software Ltd. in 2011. Cúram capacity "care and coverage" in Irish.

however an respectable for Maryland health Connection instructed CIO Journal Tuesday that whereas the trade's user adventure has greater, "tremendous issues with the Cúram software and other device accessories nevertheless deserve to be fastened before the web site can characteristic as it should still."

Some Maryland consumers' applications for insurance gain been lost or suspended in Cúram, an integral fragment of the trade it truly is designed to assess consumers’ eligibility for Medicaid and top rate tax credit for personal assurance, observed Joshua M. Sharfstein, Maryland's secretary of health and mental hygiene, and chairman of the change's board, testifying in entrance of the state Senate Finance Committee ultimate Tuesday. He too preeminent some 834 forms -- utility data the exchanges ship to insurers to comprehensive the utility process -- are generated with error, requiring trade team of workers to manually arrogate them. He too mentioned that changes to Cúram and other applications used for the website would antecedent whatever thing that had been functioning to stop working. “There are severe challenges that nevertheless remain," Mr. Sharfstein told the committee. "I don’t want to sugar­coat that.”

Cúram is infrequently the intuition behind sum the trade's ailments. In his testimony, Mr. Sharfstein spoke of the state had to mediate monetary disputes between fundamental contractor Noridian Healthcare solutions LLC and subcontractor EngagePoint LLC, which slowed technical progress in August and September. "throughout this time, there turned into insufficient growth fixing the defects identified sum through user checking out," Mr. Sharfstein mentioned. When the site went live on Oct. 1, Noridian servers used to support the exchange crashed, fighting patrons from looking for and enrolling in plans.

Noridian booted EngagePoint from the task on Oct. 25. Neither Noridian nor EngagePoint responded to CIO Journal's requests for comment.

Rick Howard, a Gartner Inc. analyst who has been intently following the fitness exchanges, pointed out complaints about Cúram bespeak the utility wasn't thoroughly built-in and verified to support the coverage transactions. "one of the most IT options that were deployed just weren't in a position for prime time when it came to the complexity demanded by means of medical insurance marketplaces," Mr. Howard stated.

however he additionally observed Minnesota and Maryland's complications depart beyond considerations with particular person software items and contractor litigation. He mentioned the exchanges tackled IT projects that were too complex in an "aggressively" brief implementation window -- most of the states took a few years to silhouette their challenge requirements -- which supposed untested programs would launch with severe defects. He spoke of he predicts HealthCare.gov and a lot of state exchanges will require persisted intensive remediation, stabilization and enhancement for the subsequent 18 months -- or longer.

Lynne Dunbrack, an IDC analyst who covers fitness permeate IT, spoke of that 50% of sum significant IT projects fail. For the exchanges, the complexity of the work, together with the integration of records between state exchanges and insurers, mixed with tight timelines, amounted to a challenge that has confirmed hard for some states to conquer. "it be in reality not incredible that we’ve considered the considerations on the scale that they now gain had throughout sum the discrete supplier solutions," Ms. Dunbrack observed.


La. social features company builds on Curam utility | killexams.com existent Questions and Pass4sure dumps

La. social features company builds on Curam utility
  • by John Moore
  • Oct 06, 2006
  • Curam application is featuring the software backbone for the currently launched first side of a social functions system mission in Louisiana.

    Increment 1 of the state’s A comprehensive enterprise Social functions gadget (ACESS) goals to deliver a standard consumption system spanning most social services classes, according to a spokesman for Curam. The initial section too covers case management for Louisiana’s child insurance scheme capabilities.

    Curam is presenting its business-off-the-shelf Social enterprise administration solutions, contracting without retard with the state. The state chosen IBM in 2004 to implement the ACESS, including the Curam utility element. final month Curam and IBM accelerated a strategic alliance to deliver human capabilities, social protection, and corpse of workers features information expertise options to govt companies. The organizations gain been partnering considering 1999.

    within the ACESS gadget, Curam’s application runs on IBM’s z/OS mainframe operating system. too working on the mainframe platform are IBM’s WebSphere utility Server and DB2 database.

    ACESS will provide Louisiana’s social capabilities agency to manage multiple programs including infant Welfare, infant Care, recommendations to Empower individuals, family unit Independence brief assistance application, Kinship permeate Subsidy software and food Stamps, among others.

    Future increments of ACESS will let caseworkers control sum of an individual’s social and human functions wants in one vicinity, the Curam spokesman said.

    Curam additionally provides its Social industry administration application to such state and autochthonous government clients as Utah and fresh york city.


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    C2170-010 exam Dumps Source : IBM Curam V6.0.4 Application Development

    Test Code : C2170-010
    Test title : IBM Curam V6.0.4 Application Development
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    : 77 existent Questions

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    Finger-pointing continues on Maryland's health exchange | killexams.com existent questions and Pass4sure dumps

    Weeks after officials at the state's health permeate exchange began blaming IBM software for the worst problems, including lost applications, IBM began pushing back, motto the state shares some of the blame.

    It's the latest salvo in the vice game that has been going on since the exchange launched, and crashed, on Oct. 1. In this case, IBM officials released a statement Wednesday that said the exchange too bears some responsibility for the website, which is still so troubled that officials are considering dumping it.

    IBM was brought in by Noridian Healthcare Solutions, the company that had been in permeate of setting up and managing the exchange website until the exchange terminated it ultimate month. IBM's Curam software was supposed to determine eligibility of consumers for subsidies, but officials gain said it's responsible for thousands of lost and frozen applications and incorrect subsidy determinations.

    "While the state notified Noridian of its concerns over the management of the project and integration of the elements of the system, it gave that integrator limited direction and exerted a lack of discipline over the evolution process, including testing," said Mitch Derman, an IBM spokesman.

    "The result was a system that didn't work as required, and Noridian has since been fired," the statement continued. "Since the launch, IBM has worked closely with the state to resolve problems and invested significant resources at no permeate to the state."

    Derman too said IBM officials recently met with Gov. Martin O'Malley to "suggest ideas to further ameliorate and finish the system."

    But it's not limpid the state plans to preserve the site going much longer after open enrollment ends March 31. On Wednesday, Dr. Joshua M. Sharfstein, chairman of the exchange board and state health secretary, repeated earlier comments that exchange officials are reviewing options that comprise adopting another state's functioning technology, such as Connecticut's, or moving to the federal exchange website or fixing Maryland's own site. He said an announcement would attain in weeks.

    In the meantime, Sharstein said the IBM software still contains many defects and the company remained on board because its workers were needed to allay fix its own product, and, as a subcontractor, is still being paid for some of its work.

    IBM now answers to Columbia-based Optum/QSSI, which was hired in December to allay fix the site and took over management when the exchange slash ties with Noridian.

    "We gain such serious challenges that there obviously is plenty of vice to depart around, but we've been very disappointed by the core software product and that product continues to be defective," Sharfstein said. IBM "does not show to be denying that."

    Noridian, which did not respond to a request for comment, has laid at least some vice on constant changes sought by the exchange.

    meredith.cohn@baltsun.com


    Minnesota Governor Blasts IBM For State Health Exchange Troubles | killexams.com existent questions and Pass4sure dumps

    Minnesota Governor imprint Dayton blamed IBM for software problems that gain stalled thousands of insurance purchases on the state's online health exchange. The exchange, MNsure, said it is bringing in UnitedHealth Group-owned contractor Optum to review operations. But MNsure may gain to accept some of the vice after taking systems integration duties from the site's generic contractor just eight months before launch.

    "Your product has not delivered promised functionality and has seriously hindered Minnesotans' abilities to purchase, health insurance or apply for public health permeate programs through MNsure," Gov. Dayton wrote in a Dec. 12 missive addressed to IBM CEO Virginia Rometty.

    The episode marks the latest specimen of a state exchange calling out a key contractor for a poorly or non-functioning online state health exchange created in the wake of the Affordable permeate Act. Oregon and Massachusetts in December called out their top contractors, Oracle Corp. and CGI Group Inc., respectively, as being key culprits behind their struggling health exchanges.

    Gov. Dayton's letter, released to the public on Friday, addressed IBM's Curam software, which was supposed to determine consumers' eligibility for Medicaid and premium tax credits for private insurance. Instead, problems gain left some applications in "pending" status. Inadequate documentation and duplicate applications gain added to the challenges, forcing MNsure staff to spend thousands of hours trying to fix the system, he said. MNsure paid IBM nearly $4 million for Curam software, as well as services and support.

    IBM spokesperson Mary Welder said the company is working "aggressively" to ameliorate MNsure. Matt Swenson, a spokesperson for Gov. Dayton, said that IBM ultimate month sent more than 80 workers -- at no extra cost to the state -- to MNsure headquarters in St. Paul.

    MNsure may gain to assume some vice for its current predicament. Since February 2013 the state exchange has served as its own generic contractor after pushing the original contractor, Maximus, to a secondary role., according to documents provided by an MNsure spokesperson. Maximus selected IBM and other software providers before designing the exchange. Taking on the generic contractor role, which includes managing the integration of various private insurance and government systems, is a tough task; the Centers for Medicare and Medicaid was heavily criticized for electing to dash the evolution and integrate HealthCare.gov. The site was plagued with a number of technical problems for months after its October 1 launch.

    Michael Krigsman, CEO of IT consultancy Asuret Inc., who reviewed Gov. Dayton's missive at CIO Journal's request, said it wasn't limpid whether MNsure's problems equivocate with IBM's software, or the way it was integrated. "The vice could be with the system integrator," said Mr. Krigsman.

    The exchange has asked Optum, the parent company of QSSI, which is currently managing HealthCare.gov and Maryland Health Connector, to conduct an "end-to-end" review of the website and suggest fixes, said MNsure spokesperson Jenni Bowring-McDonough. She said Optum will assess the functionality of MNsure's software, the site's summon center operations, as well how the agency works with its contractors. Optum will too provide a cost assay for fixing the site by next week, after which MNsure could hire Optum to execute some of the repairs.

    Meanwhile, Minnesota is conducting its own assessment. On Tuesday, Jim Nobles, the state's legislative auditor, began scrutinizing other vendors involved with structure MNsure. Mr. Nobles did not respond to a request for remark Wednesday.

    A significant revamp of the exchange is unlikely. Replacing software designed to meet Minnesota's state requirements for a health exchange and integrate with multiple government database is no easy task, said Mr. Krigsman. "Do you preserve your existing investment, or start over?" Mr. Krigsman said. "There's never enough time to procure it right, but there is always enough time to fix it."

    During a MNsure board meeting Wednesday, MNsure interim CEO Scott Leitz said that nearly 72,000 people gain enrolled through the exchange since Saturday.  He said MNsure is hiring more summon center operators and processing more paper applications to allow as many consumers as possible to procure coverage through the conclude of the March 31 open enrollment period. But he said that despite the extra allay MNsure won't gain the "ideal system" by March.


    Analysis: Health Exchange Mess fragment I: Failures in leadership | killexams.com existent questions and Pass4sure dumps

    In a two-part series Thursday and Friday, retired auditor Charles Hayward (full bio below) delves into the problems that led to a disastrous launch of the Maryland Health capitalize Exchange in descend 2013. Among the chief failings of state leadership: not addressing serious red flags when there may gain been enough time to fix the root causes; not appreciating the monumental tasks assigned to limited resources; and not selecting one IT expert to select leadership on the website’s development. He writes that by September 2013, project control was lost, a flawless storm had materialized, and officials crossed their fingers, hoping for a miracle at launch. As the smoke clears, taxpayers will underwrite hundreds of millions wasted.

    By Charlie Hayward

    CharlieHayward@MarylandReporter.com

    Whenever ineffective planning, penniless judgment and lousy communication intersect with really dismal technology in a large-scale, elevated profile, IT evolution project, a “perfect storm” of catastrophic failure is the predictable result.

    Studies of IT software-development failures panoply the deadliest of sum risks for large software projects is the “big bang” release—like the one the state of Maryland chose to implement in 2011 via its Health Benefits Exchange when it finalized plans to launch, sum at once, a versatile, multi-purpose Health Information Exchange website.

    In the first of a two-part assessment, they will examine the roles and responsibilities of the principal parties, and select an objective scrutinize at what was happening inside the exchange. Next, a brief commentary on the administration’s overwhelming desire to enroll as many people as possible and the costs of doing so. Last, they will list some of the key winners and losers and reckon the upshot on the state’s reputation from the first year of Obamacare implementation.

    Distinctive Responsibilities—The State, the Exchange, and its Contractors

    To objectively understand failure when multiple parties are involved, it is vital to esteem the distinctive roles and responsibilities of the three principal entities: the state, its newly created exchange, and the contractor, Noridian Healthcare Solutions.

    The administration of Gov. Martin O’Malley alleges contractors are to blame. That is correct, but those allegations are misleading by omission, and they suggest a lack of introspection regarding the root causes of the problems.

    Contractors’ deficient work is easy to visualize—they were project and programming experts who wrote the computer code and provided the “commercial off-the-shelf” (COTS) application from IBM/Curam—both of which failed in spectacular fashion. In contrast, the state’s overarching role and responsibilities were less visible (and more intangible) elements of success; much harder to grasp, yet vital to a successful launch.

    Sandwiched in between the state and its contractor, was the exchange. The exchange took direction from the state (via Department of Health and Mental Hygiene) and managed contractors it hired. The exchange was a small entity staffed at first (Fall/Winter 2011) with a handful or so of intellectual people trying to ramp up to about 50 employees in a hurry.

    Pearce highly qualified

    Its first hire was Rebecca Pearce, who was highly qualified to lead the exchange although she was not an IT expert. Her role was to breathe life into a fresh organization and, in doing so, she would be buffeted during the startup epoch (2012 -2013) by immense changes, as would any complex entity. The exchange was constantly in hiring mode. It was setting up internal operations departments, such as HR, IT, accounting, budgeting, marketing, customer outreach. It was setting up internal controls within those departments.

    It was singularly responsible for negotiating “Memorandums of Understanding” with six to eight different state entities who would become its industry partners. It was establishing ground rules with three federal regulators, each of which was susceptible to releasing hundreds of fresh requirements at any time. It needed to set policy supporting Obamacare implementation.

    Exchange staff met regularly with officials in the state legislature to assist them with writing three major laws; one each in successive years. It needed to establish procurement and other administrative policy. In addition to its state industry partners, it was working with a half dozen other industry partners whose operations spanned the entire state in order to scheme Obamacare implementation and establish networking and collaboration arrangements.

    For instance, the exchange was working with grassroots entities (mostly nonprofits) who would ultimately assist with program outreach to potential enrollees. It was working with the state’s pre-existing network of insurance brokers about their roles in selling products. It was involved with helping to implement which insurers would become qualified to sell products on the exchange.

    Judging from the evidence, the exchange and its small staff did a remarkable job, except with respect to the website platform.

     Meanwhile, the state’s big-bang vision posed a major risk of a big-bang-boom outcome, assuming the best compress management practices and system-development principles had been followed. The state wanted to lead sum others in Obamacare implementation, so it conceived of a website with sum the bells and whistles; its leaders were seemingly oblivious regarding the quiescent risks attendant to its vision. Ultimately, the exchange never implemented the best compress management practices and system-development principles that would gain given the project any casual of success.

     As the facts surrounding the website platform’s failure emerge, they will observe a domino upshot of separate (and successive) failures: State of Maryland ? Exchange ? Noridian. Gov. Martin O’Malley administration’s failures ultimately led to organizational and management breakdowns within the exchange. Ultimately, the state’s and exchange’s failures did not antecedent contractor failures, but they created the atmosphere which precluded the exchange from identifying the gravity of Noridian’s problems in a timely manner, and taking immediate and definitive action to ameliorate the root causes of the early warnings. Hence, the “perfect storm.”

     State of Maryland

    The O’Malley/Brown administration, including Secretary Joshua Sharfstein, M.D., should gain known that the exchange’s workload was too much for its nascent staff to manage, and they should gain taken definitive action after major red flags in November 2012 of impending failure. Specifically, these leaders:

  •  Failed to esteem the drain on the exchange’s limited resources from the plane of endeavor needed for exchange startup activities during 2012 – 2013, and the distractions these activities would create relative to the concurrent website platform build. observe this chart showing milestones for the exchange’s myriad startup responsibilities. Sharfstein was vigilant that startup activities were, in fact, undergoing significant “mission creep” during these years—not captured in the chart’s static milestones.
  • Misjudged the risk in the website build. Either they did not fully identify specific risks common to ample bang releases, or they performed risk assessments that were ineffective.
  •  Did not assure the exchange was supported by sufficient, qualified IT resources during the website platform build to properly manage and control that work.
  • The Exchange

    The exchange did not gain a single individual assigned to manage Noridian’s work who was proficient with large-scale IT evolution projects who had ultimate authority and complete responsibility. The U.S. Government Accountability Office has been recommending this approach in countless reports over the ultimate 15 years. (As an aside, the exchange will utilize this approach during the build using technology from Deloitte Consulting, which provided successful technology in Connecticut. Isabel Fitzgerald, the state’s chief IT expert, will manage. The role of Fitzgerald in the Deloitte build stands in stark contrast to the organization model existing during the failed Noridian build.)

    The exchange’s project management resources were spread among many contractors who were being managed by a diffuse control structure. Thus: roles, responsibilities and lines of authority became hopelessly blurred. And so it was no surprise that as the Noridian build evolved, communication broke down, critical-path schedules weren’t used, contractors set their own priorities and performed work in righteous faith but outside their contracts’ specifications.

    Endless meetings ultimately turned counterproductive, as the challenge of working with multiple contractors led to tradeoffs between resolving contractor conflicts versus fixing exchange bugs. Deadlines passed without remediation. Sheer chaos was pervasive in the ultimate few weeks before website launch.

    The exchange’s key managers did not know what functionality the site would gain as of the launch date, because time expired before platform testing was finished. Incredibly, they would depend on launch “glitches” to pinpoint the True state of functionality. They’d crossed their fingers and flipped the switch, hoping for a miracle.

    These conditions are discrete from BerryDunn (quality assurance contractor) monthly reports issued during the website platform build. They are the ratiocinative result of the O’Malley administration’s leadership errors described above.

     Contractors

    Problems between Noridian and its subcontractor EngagePoint, Inc. are well known. So too are the major dysfunctions within the IBM/Curam toolsets, industry processes, and interfaces at the core of Maryland’s website platform. Noridian claims its problems were partly attributable to changes in federal requirements, particularly Jan. 17, 2013 release by the Centers for Medicare and Medicaid (CMS) of 70 industry functions that the website was required to achieve.

    But Noridian should never gain bid the work without fully appreciating the major risks inherent in Obamacare implementation, particularly HHS’ episodic, last-minute changes flowing down into Maryland’s website specifications. Other states faced the very changing specifications and their contractors succeeded.

    Noridian owned these problems because it bid the work and signed the compress expressly requiring it to endure a elevated degree of performance risk. As such, Noridian was responsible for fixing its problems. Absent Noridian’s fixes, the state was responsible to replace Noridian and execute contingency plans or risk catastrophic failure. By the time these options were clear, the exchange was trapped like a deer in the headlights; it had no contingency plan. It was too late to execute anything.

    Success—At what cost?

    By most measures, the O’Malley administration succeeded in its goal of maximizing enrollment, having comfortably exceeded its downsized goal of 260,000 sign-ups. In the process of enrolling somewhere near 300,000, Gov. O’Malley, Lt. Gov. Brown, Dr. Sharfstein (Department of Mental Health and Hygiene head) and key people in the exchange arguably suffered from a severe case of tunnel vision.

    In the aftermath of O’Malley’s determination to scrap the website platform and award $70 million or so of no-bid contracts to Optum/QSSI and Deloitte Consulting, the state legislature and taxpayers are asking about accountability for—let’s summon it $300 million of sunk costs, and counting. Who is to vice and what will be their fate? Will there be restitution?

     Winners and losers—and reputational costs

    The newly insured are winners, particularly those covered by Medicaid’s expansion. About 96,000 people covered under the legacy Medicaid program were automatically enrolled in expanded permeate (i.e., non-emergency hospitalization) that was unavailable under the dilapidated Medicaid program’s primary-care benefits.

    And a fresh cohort of Medicaid beneficiaries — the exchange doesn’t gain final numbers, because the website failure caused many applicants for Medicaid expansion to be set in a queue, pending results of case-by-case eligibility determination at a later time. So the enrollee signify seems to be somewhere between 132,000 and 150,000.

    Still another cohort of winners (63,000 as of April 4) has purchased subsidized insurance under private plans sold in the exchange. Many will learn, however, that subsidized premiums are affordable but the health permeate itself is not—once the bills for deductibles and co-pays attain due.

    The limpid winners too comprise many high-priced “white shoe” consultants who were able to capitalize on the exchange’s failure to implement and operate the software infrastructure it contracted to build. Possibly the biggest winner may be crowned in years to come: the tort lawyers.

    The losers comprise people who formerly were insured for lesser coverage, but were required under threat of penalty to buy more expensive coverage, exceeding their needs. And then there are the people who simply settle against any of Obamacare’s options because they gain better ways to spend their money. They will be required to pay the “penalty-tax.”

    Probably the biggest losers are thousands of helpless taxpayers who paid for the dysfunctional site and the many cascading effects (described in the second installment) associated with its failure. Those taxpayers then paid to preserve the website open long enough to limp through the first year’s enrollment.

    Then they will now pay Deloitte and others millions to (1) plug another state’s solution into Maryland’s milieu, and (2) reconstruct a single database of record—from information that is now spread over mountains of paperwork from manual workarounds or are unsalvageable or hopelessly irretrievable from Curam.

    Obamacare so profoundly changed the insurance landscape that government entities gain commandeered the role of selling insurance products formerly held by the private sector. A private company has a righteous reputation when it consistently meets or exceeds the expectations of its customers. A dismal reputation results when the organization’s words or deeds descend short of customer expectations.

    How would people view the credibility of state leaders if they were private-company executives engaging in the kind of tunnel vision, penniless planning, mismanagement and spin, described above?

    Charles Hayward spent more than 30 yers performing Government Accountability Office full-scope “yellowbook” audits and served as a confederate in two accounting firms. He retired in Nov. 2007 from Cotton & Company LLP, where he was a confederate and principal fiscal auditor of the firm’s audit drill group. He led audits of many federal agencies, including the U.S.Department of Justice, Department of Commerce, Government Accountability Office and the Small industry Administration. He earned a bachelor’s degree with honors in industry Administration from Bowie State College, and attained every auditing-related certification, including CPA, CISA, CFE and CGFM. Since retiring, he has worked on a few consulting assignments and been a contributing writer for MarylandReporter.com, specializing in audit coverage.



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