Another nail in Vermont Health Connect’s coffin

The vultures are circling. The wolves are howling. The diminished corpus of Vermont Health Connect is crawling across a pitiless landscape; every time an oasis appears, it turns out to be a mirage.

Things aren’t lookin’ good.

I’ve been a strong supporter of Governor Shumlin’s health care reform plan — hopefully as a first step toward single payer, or at least universal coverage of some kind. I have bought and consumed every confident reassurance ever issued by the Governor and his minions. I have, unfairly in retrospect, mocked his critics as mindless partisans. I have allowed my hope to be renewed by fresh reassurances, most recently last fall, when the administration announced that VHC had met its performance benchmarks.

Today, not so much. Today I’ve turned a corner. I remain hopeful, but the confidence is gone.

The last straw was yesterday’s article by VTDigger’s Erin Mansfield, which began like this:

An independent expert on health care strategy advised the state to spend as little money as possible on Vermont Health Connect technology in the immediate future and instead use resources to evaluate alternatives to the exchange.

Frank Petrus, a senior managing partner at Connecticut-based Gartner Inc., told lawmakers the state should stop spending money to build new Vermont Health Connect technology, try to leverage investments it has already made, and commission a study that would take three to four months.

Basically, he wants to put VHC into hospice care. Stop trying to fix it, just help it “limp along a little while longer.”

Ugh. Yeesh. Aaaaaarrrrrgh.

This isn’t coming from a free-market ideologue, but a guy with unimpeachable bona fides:

Gartner has consulted for several state health exchanges, including Vermont Health Connect, and has a great deal of experience in public sector human services.

Republicans are jumping on this as an argument for immediate termination of VHC and connection to the federal exchange. Petrus cautions that things aren’t so simple, that the next step requires careful consideration and study. But he’s not talking about making VHC work; he’s talking about “remediation” and coming up with a new plan to move forward in, say, several months’ time.

Side note: i hope that health care chief Lawrence Miller has had second thoughts about his recent hot blast at Mansfield for “slanted journalism” full of “factual inaccuracies” that “creates an inaccurate perception,” and his conclusion that “I will not work with her anymore.”

Seems like Mansfield’s reporting was closer to the truth than Miller was inclined to admit.

Petrus’ assessment comes on the heels of warnings from two very different sources: Blue Cross Blue Shield of Vermont, and Vermont Legal Aid. The former wants an independent review of VHC, and the latter is fielding scores of complaints:

“We’re going backwards,” said Trinka Kerr, the chief health care advocate for Vermont Legal Aid. “Towards the end of last year, we were making progress. You could get things straightened out relatively quickly, and now things are more complicated than they used to be.”

Since I am, by self-definition, a Vermont Political Observer, let’s get to the politics of the situation.

For the Republicans, it’s Christmas in February. For the Democrats, it’s bad. Really bad. Vermont Health Connect will go a long way toward defining the legacy of the Shumlin years. To some extent that’s unfair; but Shumlin himself is largely responsible for the situation. He has issued so many reassurances, so many denials of trouble, so many sunny forecasts, that he has lashed himself to the mast of the Good Ship Vermont Health Connect. It if ends up hitting the rocks, he’ll be on the record as captain.

For the rest of the Democrats, well, this will remain an open issue for most of 2016 at least. As Petrus says, you can’t just pull the plug and walk away. It takes time, and it takes a plan.

Look forward to the months ahead, fellow liberals. The Democrats will be playing defense, and the Republicans will be freely firing their rhetorical artillery. The longer this goes on, the better Phil Scott’s brand of sober, unimaginative, guy-next-door style is going to look. Sue Minter is going to be tarred, fairly or unfairly, by her association with the Shumlin administration. Matt Dunne’s tech-expert assurances that in his administration “the websites will work” may be completely accurate, but they will sound awfully hollow after years of VHC failure under Democratic management.

Maybe I’m overreacting. Maybe Lawrence Miller will pull a rabbit out of his hat. If so, then the script will flip. For now, the Republicans have a big fat opportunity that’s been crafted, as if to their specifications, by the Shumlin administration itself.

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6 thoughts on “Another nail in Vermont Health Connect’s coffin

  1. bobzeliff

    I see this your response to to this extremely disappointing sequence of events as short of shallow dancing for joy of Vermont’s failure.

    Journalism should be more than regurgitating some showy head line facts, it should also inform and educate. Yes that is more work!!

    By Obama care law we had to implement the exchange. (One can clearly argue that we Vermont’s were doing a better job of healthcare reform with out Obama Care..but that is a moot issue now).
    Second our state Information Technology infrastructure was (and still is with out fixing) a bunch of out of date different data silo’s. The state IT infrastructure hoped to use Obama care IT funding to solve both problems with strong support of the Shumlin Administration. Good forward thinking.

    The problem has been with the implementation.

    The State’s IT managers thought they knew how to manage in re architecting the state’s health care infrastructure. They did not. The Shumlin administration did not put in place adequate IT architect management to recognize let alone lead the State’s IT managers.

    Neither Shumlin admin or State’s management team was skilled enough to manage Software development contracts with large sophisticated company.

    GCI took the money, dropped the ball and ran away with a pile of money!

    In the last year, despite more money and more people they have proven not to be up to the task.

    To my knowledge the state still not has hired a Sr. Level Software development and business manager to lead this project hands on! (This skill set does not exist in state government and like not in the State (Dealer.Com may be the exception) The State is relying on IT managers, both in eternal and external to run this project, not that these are not hard working or bad people, they are just not of the skill set to be up to the task.

    PS I understand the legislature has hired an retired State IT manager to advise them. I’m sure he is a great individual, but he is almost certainly not of the right skill set to give the legislature the best advice on how to go forward!

    an analogy

    Vermont has users of software applications…ie state health connect staff analogous to truck drivers.

    Vermont has an IT staff that maintains (not designs) the software analogous to truck maintenance staff.

    Vermont has no Health Care software architect or designers. These people are highly skilled
    and would not likely be or stay in state employ due to lack of long term challenge and Money.

    Analogous to truck architect and design engineers; motor, transmission, electronics etc.
    It is these architect and management skills we seem to still not have.

    Bottom line that fact the Vermont has not proven up to properly manage this effort does not mean the core thrust of the project is wrong, not needed, or should be abandoned.

    Reply
  2. Brooke Paige

    Get out the oak stake, time to put this one to a peaceful end without spending too much more on the funeral flowers.

    Rest in Peace .- Vermont Health Connect !

    Hey, while we’re at it how about we unburden ourselves of the bloodsucking Green Mountain Care Board and its fearless leader “French Fry” Al ?

    I’m just sayin’ !

    Brooke

    Reply
  3. Walter Carpenter

    “Green Mountain Care Board and its fearless leader “French Fry” Al ?”

    Why would you want to do that and return to the largely unregulated bliss that the medical-industrial complex in Vermont enjoyed before the board and “french fry” Al began to watch what they were doing. With the board, system costs are rising at the lowest rate in many a year. Without the board you’d be really screwed on health care costs. As for VHC, it is a clog in a deeply flawed law which should best be described as the “private insurance self-preservation act,” written by lobbyists who spent a million a day lobbying Congress for this law.

    Reply
  4. Cynthia Browning

    First, I think that the new legislative staff IT expert in JFO has the skills to provide the Legislature with the independent advice and guidance that has been lacking all through the VHC debacle. He has already provided analyses of other projects, and they are well prepared and extremely useful. I am hoping that whatever step is taken next he will continue to prove the value of an expert that works for the Legislature and not the Administration.

    Second, the problems with VHC go back to over ambitious policy goals from the git go: given the Federal deadlines we should have done the most basic exchange possible, and not mandated that anyone other than those without coverage from employment go through it, and not tried to build a platform preparing for “single payer” at the same time. No IT system will be able to save ill advised and reckless policies. This is not 20-20 hindsight — I know that I was one of those warning that since we did not know how the exchanges would work out, we should not mandate participation and we should start small. So the original sin was that the Administration and the Legislative majority were so eager to look past the exchange to single payer (which they did not know how to pay for) that they forgot that you have to go step by step, and that modest reliable improvements are better than ambitious visions that are never realized.

    In his testimony before House Corrections and Institutions, Mr. Frank Petrus of Gartner said that we should hit the pause button on VHC and have an evaluation done about how to move forward. This might cost $500,000 and take 14 weeks. He said that among the alternatives that should be considered are: 1) copying what Hawaii did successfully with their exchange using some of the same Oracle software that we already have; 2) discarding the dysfunctional components of our system (One Gate?) and improving the systems we have differently than Hawaii; 3) going to using another state’s already functioning exchange entirely; or 4) transitioning to the Federal exchange.

    The key is that the practical analysis of what is possible and advisable in renovating what we have or obtaining access to another system should be what guides the decisions: whether and how soon and with how much cost we can get functionality for Vermonters. Thus far, I am sorry to say, politics has consistently dominated practicality in this area with this Administration.

    Rep. Cynthia Browning, Arlington

    Reply
  5. ApacheTrout

    This is a failure of database and IT management (and contract management over CGI), yet its aftermath spills over into the health care reform debate. The inability of Shumlin and his administration to successful implement Health Connect is stunning, especially considering there are only two insurers in the system. Just remarkable incompetence.

    That said, I’d very much like the next attorney general to investigate the fraud that CGI pulled while billing Vermont for an incomplete and faulty product.

    Reply

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