The HealthCare.gov rabbit hole: Where's the data going?

HealthCare.gov's front-end problems for users has led to back-end issues with insurers as well

HealthCare.gov's biggest performance issues may not be on the website. Rather, they appear to be with the wealth of third-party insurers that the site delivers information to about prospective clients.

The New York Times reported earlier this week how one of the biggest remaining problems with the site isn't the slowness of the enrollment process. Instead, it's how the information gathered from prospective customers isn't being properly delivered to insurers, thus causing further delays in the enrollment process.

The problems with the site, as far as insurers are concerned, fall into roughly three buckets:

  1. Those who signed up for a plan through the site, but later found that the insurer in question never received their signup information.
  2. Those who signed up and had their information transmitted -- but only partially, forcing the insurer to perform some detective work to complete the application.
  3. Those who've been signed up, but whose insurers haven't been told how much of their premium will be subsidized by the government, causing further delays.

The Washington Post went into some detail about the ways data provided to insurers by HealthCare.gov were falling short. The culprit was the "834 forms," or the paperwork sent out nightly to insurers to notify them of new subscribers. Said forms were often missing data or contained redundant data, such as duplicate enrollments.

According to the Post, some one-third of the people signing up since Oct. 1 had incomplete 834 data sent to insurers. The White House disputes this number and claims that as of right now, less than 0.5 percent of the site's users should experience problems with 834 form data. And the White House said late Wednesday it was readying a fix in cooperation with the insurers.

But one passage in the Post's article sheds light on how those mistakes might well have arisen in the first place. According to a "senior official on the project," some errors "in the past [834] forms were generated by the way people were using the system ... such as clicking twice on the confirmation button or moving backward and forward on the site."

If that's true, it's a distressing indictment of how the site's architecture wasn't designed to properly preserve user state during the course of a transaction, something any modern website ought to be engineered to deal with. (As Wired put it, "Obamacare website is in great shape -- if this were 1996.")

There's little question the site's user-facing performance has increased enormously since its troubled October launch. Reuters has reported that more people signed up on the site in the first two days of December than they did for the whole of October. A progress report (PDF) for the site, released over the weekend by the Department of Health and Human Services, noted that "hundreds of software fixes, hardware upgrades, and continuous monitoring" had "measurably improved the consumer experience."

Stephen Wilson of application performance management firm Compuware APM has been monitoring the performance of HealthCare.gov on a state-by-state basis since October. In his view, many of the long-standing problems with the site's user-facing experience haven't been addressed. "It does not matter that 50 new servers were brought online when they are still pushing megabytes of uncompressed content to the browser," he tells InfoWorld's Eric Knorr. "We were not able to get deep visibility behind the scenes of the server side, but we were still able to capture and compare what is sent to the end-user. From that perspective, nothing has changed."

This story, "The HealthCare.gov rabbit hole: Where's the data going?," was originally published at InfoWorld.com. Get the first word on what the important tech news really means with the InfoWorld Tech Watch blog. For the latest developments in business technology news, follow InfoWorld.com on Twitter.

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