Harvard Case - HealthCare.gov: The Crash and the Fix (A)
"HealthCare.gov: The Crash and the Fix (A)" Harvard business case study is written by Leonard A. Schlesinger, Paras D. Bhayani. It deals with the challenges in the field of Organizational Behavior. The case study is 20 page(s) long and it was first published on : Jun 9, 2015
At Fern Fort University, we recommend a multi-pronged approach to address the challenges faced by HealthCare.gov. This approach focuses on improving organizational culture, leadership, and communication, while simultaneously bolstering technical infrastructure and implementing robust testing procedures. This strategy aims to foster a culture of accountability, collaboration, and continuous improvement, ultimately leading to a more resilient and effective website.
2. Background
The case study revolves around the disastrous launch of HealthCare.gov, the website designed to facilitate enrollment in the Affordable Care Act (ACA). The website suffered from numerous technical glitches and performance issues, leading to widespread public frustration and criticism.
The main protagonists are:
- Henry Chao: The Director of the Center for Medicare and Medicaid Services (CMS), responsible for overseeing the website's development and launch.
- Kathleen Sebelius: The Secretary of Health and Human Services (HHS), tasked with leading the overall implementation of the ACA.
- The development team: A group of contractors and government employees responsible for building and testing the website.
3. Analysis of the Case Study
The case study highlights several key issues:
- Leadership and Communication: The lack of clear leadership and communication within the project team contributed significantly to the website's failure. There was a lack of coordination between different teams, leading to conflicting requirements and delays in development.
- Organizational Culture: The project's culture was characterized by a siloed approach, with teams working in isolation and lacking a shared understanding of the project's goals. This led to a lack of accountability and a failure to identify and address problems early on.
- Technical Challenges: The website was built on a complex and untested platform, leading to numerous technical issues. The development team lacked sufficient time and resources to adequately test the website before launch.
- Project Management: The project lacked a clear and comprehensive plan, resulting in missed deadlines and a lack of transparency. The project was also plagued by unrealistic timelines and a lack of effective risk management.
Framework: We can analyze the case using the 7S Framework developed by McKinsey & Company. This framework examines seven key elements of an organization:
- Structure: The project's structure was decentralized and lacked clear lines of authority, leading to confusion and inefficiency.
- Strategy: The strategy for building and launching the website was unclear and lacked a comprehensive plan for addressing potential challenges.
- Systems: The systems used for development and testing were inadequate and lacked the necessary robustness to handle the website's complexity.
- Style: The leadership style within the project was characterized by a lack of transparency and accountability, leading to a culture of blame and mistrust.
- Staff: The project team lacked the necessary expertise and experience to build and launch a website of this complexity.
- Skills: The skills and knowledge of the project team were insufficient to address the technical challenges of the project.
- Shared Values: The project team lacked a shared understanding of the project's goals and values, leading to a lack of focus and direction.
4. Recommendations
1. Establish Strong Leadership and Communication:
- Appoint a dedicated project manager: This individual should possess strong leadership skills, technical expertise, and experience in managing complex projects.
- Implement clear communication channels: Establish regular meetings, project updates, and clear communication protocols to ensure all stakeholders are informed and aligned.
- Foster a culture of collaboration and transparency: Encourage open communication, feedback, and collaboration between different teams.
2. Transform Organizational Culture:
- Promote a culture of accountability: Establish clear roles and responsibilities, and hold individuals accountable for their actions.
- Encourage continuous improvement: Implement feedback mechanisms and encourage teams to learn from their mistakes and continuously improve their processes.
- Foster a sense of ownership: Empower teams to take ownership of their work and contribute to the project's success.
3. Enhance Technical Infrastructure and Testing:
- Adopt a robust and proven platform: Choose a platform that is well-tested and capable of handling the website's anticipated traffic and complexity.
- Invest in rigorous testing: Implement a comprehensive testing plan that includes functional testing, performance testing, security testing, and user acceptance testing.
- Develop a comprehensive disaster recovery plan: Ensure the website has a robust disaster recovery plan in place to minimize downtime and ensure continuity of service.
4. Implement Effective Project Management:
- Develop a detailed project plan: Define clear milestones, timelines, and resources for each stage of the project.
- Implement risk management procedures: Identify and mitigate potential risks throughout the project lifecycle.
- Establish clear metrics and reporting mechanisms: Regularly track progress, identify areas for improvement, and communicate results to all stakeholders.
5. Basis of Recommendations
These recommendations are based on the following considerations:
- Core competencies and consistency with mission: The recommendations align with the core mission of the ACA to provide affordable healthcare to all Americans. They also focus on building a website that is reliable, secure, and easy to use.
- External customers and internal clients: The recommendations prioritize the needs of both external customers (citizens seeking healthcare) and internal clients (government agencies and healthcare providers).
- Competitors: While there are no direct competitors to HealthCare.gov, the recommendations aim to ensure the website is as user-friendly and efficient as possible, creating a positive user experience that meets or exceeds expectations.
- Attractiveness: The recommendations are expected to lead to a more efficient and effective website, resulting in increased user satisfaction, reduced costs, and improved public perception.
6. Conclusion
By implementing these recommendations, HealthCare.gov can overcome its past challenges and become a successful and reliable platform for accessing healthcare. The key to success lies in fostering a culture of collaboration, accountability, and continuous improvement, while simultaneously investing in robust technical infrastructure and rigorous testing procedures.
7. Discussion
Alternatives:
- Outsourcing the entire project: This option could have provided access to specialized expertise and resources, but it could also have led to a lack of control and transparency.
- Delaying the launch: This option could have allowed for more time to test and refine the website, but it would have also delayed the implementation of the ACA.
Risks:
- Resistance to change: The recommendations may face resistance from individuals who are comfortable with the existing processes and culture.
- Budget constraints: Implementing these recommendations may require significant investment in resources and technology.
- Technical challenges: The recommendations may still encounter unforeseen technical challenges.
Key Assumptions:
- The government is committed to investing in the necessary resources to implement these recommendations.
- The project team is willing to embrace a culture of collaboration and continuous improvement.
- The technical challenges can be overcome with sufficient expertise and effort.
8. Next Steps
- Form a dedicated project team: This team should include representatives from all relevant stakeholders, including technical experts, project managers, and communication specialists.
- Develop a detailed project plan: The plan should outline the specific steps, timelines, and resources required to implement each recommendation.
- Implement a pilot program: Conduct a pilot program to test the effectiveness of the recommendations before rolling them out to the entire website.
- Monitor and evaluate progress: Regularly track progress, identify areas for improvement, and make adjustments as needed.
By taking these steps, HealthCare.gov can overcome its past challenges and become a successful and reliable platform for accessing healthcare.
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Case Description
A review of the process utilized by the Obama administration to create the Health Care.gov exchange and the problems that resulted from the implementation effort. There is a B case that provides the follow on strategy and processes utilized to get the site up and running after the initial failures of implementation.
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