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Several Factors Hobbled MNsure From the Start


"This is really a technology project," she said. "One of the challenges is the [MNsure] leadership viewed this from a health policy standpoint and not from an IT technology implementation standpoint, and I think that drove a lot of the challenges along the way."

Insurance company executives also complained that the Legislature denied the industry a seat on the agency's board over concerns about a conflict of interest, so tough questions about the site's technological infrastructure weren't asked early or frequently enough.

When MNsure went live, its technical flaws emerged quickly. Some people were locked out of their applications, while others struggled to find out if they were eligible for financial assistance. MNsure didn't run well on certain web browsers, and many users were confronted with frozen screens.

MNsure officials might have known about many of these problems if they had tested the site with consumers prior to Oct. 1.

But, as agency officials rushed to make their deadline, they say they didn't have time to do what IT consultant Michael Krigsman calls a cardinal rule of technology development.

Testing "is one of those things that's so foundational, it doesn't even deserve a 'Why?'" said Krigsman, who specializes in preventing IT projects from failing. "It's like, 'Why do we need to breathe the air?'"

Off-The-Shelf And Untested

In 2011, Minnesota counties were helping the Department of Human Services vet software for a massive overhaul of the state's outdated system that calculates someone's eligibility for Medicaid or other public assistance.

County workers process Medical Assistance applications and MNsure was supposed to automate the application system.

Ramsey County Community Human Services director Monty Martin said software developed by IBM Curam stood out among the products the counties analyzed, partly because other states used it and it was "off-the-shelf."

In other words it wouldn't have to be built from scratch, and could be reconfigured to fit Minnesota's specific needs. Eventually, MNsure would serve as a portal for determining eligibility not just for Medicaid, but also for other public assistance programs, such as food and child support. The Curam software would be used to determine eligibility for those programs, too.

Martin said the state and counties were anxious to avoid another HealthMatch, an expensive and failed IT program under the Pawlenty administration that was meant to improve eligibility calculations.

"We in the county had reached an independent conclusion that commercial off-the-shelf products were the direction we would need to go generally in government because development of our own software pieces was much too expensive and hard to maintain," Martin said.

But what the state ultimately licensed from Curam was a product that wasn’t actually tested.

And even though Curam's existing products appeared to work well for other states, one major consulting firm seeking to win the MNsure contract was leery.

Wed, Mar 12 2014

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