The Nevada Health Exchange is Still a Hot Mess

Nevada’s health exchange is still plagued with problems that were foreseeable weeks or even months before the October launch.

Back in October, I did a deep dive on the development of the Nevada Health Exchange titled “A Case Study in What Went Wrong.” What I found was a disaster in the making. The project was behind schedule and with only weeks left to go, testing had barely begun. One website contractor tasked with overseeing progress wrote that the 10/1/2013 go live date” was “in jeopardy.” The situation was so dire that it was necessary to elevate the concerns to the Governor’s office (though even that didn’t seem to help).

Anyone looking over the project status reports, full of bright red color coding to indicate elements which were not on track, could see the rollout was going to go poorly. And that’s exactly what happened. And nearly four months later, according to a report Tuesday by Jennifer Robison for the Las Vegas Review Journal, the Nevada exchange is still a hot mess:

The exchange’s problems show most dramatically in enrollments. More than
1 million consumers had visited the website by Jan. 11, but only 13,159
paid sign-ups were recorded by Jan. 22. That’s a conversion rate of 1.3


The exchange has two more months to meet its goal, but enrollments are
trending against it. Plan selections peaked at 4,933 from Dec. 23 to
Jan. 4, but fell to 1,535 between Jan. 11 and Jan. 18. Paid enrollments
dropped from 4,328 between Dec. 23 and Jan. 4 to 1,750 between Jan. 11
and Jan. 18.

One of the specific problems I highlighted in October was the inability of the Nevada exchange to electronically transfer enrollment data to insurers. I wrote “Because of the unresolved EDI 834 problems the current enrollment
process for Nevada’s exchange is to print out completed applications and
physically deliver them to the insurance carriers.” The Review-Journal reports this has indeed caused a problem:

A Las Vegas insurance broker said the exchange delivered “a box of
printed paper applications” to Health Plan of Nevada, the state’s
biggest insurer, so that staffers write policies by hand. That’s caused a

The story concludes that Xerox, who had the multimillion dollar contract to build the site, is “universally blamed” for the problems. That may be so but it’s nevertheless true that Nevada officials knew they were not ready for the launch date and chose to say nothing. Even after the site opened and clearly had significant problems, spokespeople for the Nevada exchange blamed traffic rather than poor programming or a lack of testing, i.e. things over which they had control.


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