Healthcare.gov Risk Management Report: A Case Study

Desklib provides solved assignments and past papers to help students succeed.

Table of Contents
1. Introduction:........................................................................................................................2
2. Objectives:..........................................................................................................................2
3. Risk Management Methodology:........................................................................................4
4. Detailed Investigation:........................................................................................................6
4.1 Establishing the context – Internal and external:.............................................................6
4.1.1. Internal Factor affecting Healthcare.gov project:....................................................6
4.1.2. External factors influencing the healthcare.gov website;........................................7
5. Risk Assessment:...............................................................................................................8
5.1 Risk identification:...........................................................................................................8
5.2 Risk Analysis:................................................................................................................10
6. Risk Evaluation:...............................................................................................................10
7. Risk register:....................................................................................................................12
8. Risk Treatment Schedule and Plan..................................................................................15
9. Risk Action Plan..............................................................................................................19
References:...............................................................................................................................24

1. Introduction:
Data digitization concept dated back to 1960s but practically came into effect in early 90s
with the onset of Internet. Governments are utilising e-government websites for providing
day to day services to their public (Kim et. al,2007). E-government projects are considered as
tedious, as stakeholder or the end user, that influence and are influenced by the project is
“Public” of that country itself. The other factors that added complexity and uncertainty to
these e- government projects are the exceptional size of the governmental organisation,
opposition to changes, political factor and user impact. Moreover, inadequate project
management and lack of public trust; high expectations; resistance to adopt new
technological advancements, political engagement proves to be the barriers for the success of
these e-government projects. As (Heek, 2007) elaborated from his search that only 15 % e-
government project are fully functional and successfully working up to the user’s
expectations while other being partially or wholly a disaster.
In this project report, we are investigating Healthcare.gov insurance exchange website which
is a United States federal government project for 36 states across the country. But, it turned
out to be a total IT disaster during its implementation phase, as it does not meet the basic
needs for its functionality and remains inactive for a month (Gao,2013). We are assuming
that project is being reviewed again thoroughly, and our group is working as Risk
Management Consultancy to determine the risks, its impact and put forward Risk
Management Plan including mitigation strategies. In the following sections we are projecting
the possible risks that was ignored by the developers and looking forward to identifying more
loop holes for Helathcare.gov websites and applied the previous lessons learned from its
failure. This document has been divided as: section 2 contains Risk Management
Methodology adopted. Section 3: Detailed Investigation of the possible risks, and its
analysis, Section 4 contains Risk Register.
2. Objectives:
Healthcare.gov also known as “Obamacare” which was developed to serve residents from 36
different states in United States of America in 2013.U.S. Federal Government along with
Centre for Medicare and Medicaid Services was responsible for this vast project. We believe
that success of each project depends largely on the goals and objectives set initially and how
that goals are achieved during the development phases. During the testing phase, if developed

project direct towards the objective set earlier: total success otherwise disaster. Initially,
Healthcare.gov project’s main objectives according were:
 To make insurance policies available to all residents at low cost among 36 states of U.S.
 It allows resident to compare the insurance plans in their respective states and chose the
best that suits their requirements.
 People can check their eligibility for the subsidies that in return will reduce the household
expenses for the poor people below defined poverty line.
 To revolutionise the way of decision making in healthcare field in America, by decreasing
the insurance policies expenditure and collaborating with the insurance companies all
around the United States.
 To promote the Medicaid facilities in selected states using the advanced planning
techniques that will prepare policy holders for the potential risk that may happen in future
through e- gov website.
As a Risk Management Consultancy for healthcare.gov project we need to identify the
potential risks that may affect this project. We have set some objectives to be undertaken by
us before identifying and analysing the risk. These objectives help us to be focus and align
our work in the defined direction:
Risk Consultancy Objectives are:
 Detailed risk analysis by considering the lessons learned from the failure of similar
projects happened before.
 Determine positive risks that can be converting to opportunities and negative risk that
possesses possible threats to the project.
 To access the project according to the urgency, legitimacy and power of the internal and
external factors influencing the whole website.
 Inform the developers to Re-engineer few project processes to prevent or avoid the risk
and decrease its impact towards the progress of the project.
 Suggest risk mitigation techniques to mitigate the risk smoothly.
 Communication upward with the management and create awareness about the risks.
Our team is working to accomplish these goals and create a risk management report for the
senior management team and developers.

3. Risk Management Methodology:
With the time and requirement, the Risk management processes have evolved and improved
continuously during the last decade which led to the development of various processes,
procedures, methods and techniques to manage the uncertainty. Various standards for risk
management have been suggested and implemented at different time by different authors. For
the standardisation of this process, nine standards are listed among which six applied to the
projects and three are for organisation (Hilson,2005). We are using one of the standards
known as AS/ NZS 4360: 2004 Risk Management for our healthcare.gov project which was
put forward by the Standards Australia/ Standards New Zealand in the year 2004. The reason
for choosing this standard is it allows us to define the planning steps according to our
requirement and help to identify, analyse and develop mitigation strategies more effectively
as required by the healthcare.gov website. The various steps involved in AS/NZS 4360: 2004
as according to the Standards Australia/Standards New Zealand (2004):
 Establishing the internal and external context
 Risk Identification (What, how and Why it happens)
 Risk Analysis:
 Qualitative and quantitative analysis
 Evaluation of the risk
 Documenting Risks
 Risk Management:
 Risk management strategies
 Assessing the risk management strategies
 Implementing risk mitigation plan.

We have planned our risk planning process according to the above defined standard and
prepare a risk register. The step by step implementation of above phases mentioned are
discussed in detail in the following section.
## Standards Australia/Standards New Zealand (2004) Australian/New Zealand Standard
AS/NZS 4360:2004: Risk Management. Homebush, NSW: Standards Australia /
Wellington: Standards New Zealand.

4. Detailed Investigation:
Sources of information: To gain knowledge about the healthcare.gov website and analyse
the case study for the academic perspective, our search includes journals in science direct,
Elsevier and Springer. Search was undertaken using the keywords “healthcare.gov”,
“Obamacare”, “Healthcare.gov IT disaster”, “e-gov website failure”, “IT disaster in U.S”,
“healthcare.gov failure analysis” and “healthcare.gov project” and articles are searched since
2014 and more than 7000 articles were displayed. More than 20 papers were studied available
on google scholar, some reports and document available on google were considered to gain
proper understanding of the case study.
4.1 Establishing the context – Internal and external:
Internal and external factors need to be considered thoroughly while analysing the risk as
they affect the progress and objectives of the project. Some factors can be controlled while
others not. Internal factors are strength and weaknesses and external factors are opportunities
and threats. We have identified factors and categorised on the basis whether they exist inside
the organisation or outside the limits of an organisation.
4.1.1. Internal Factor affecting Healthcare.gov project:
 Organisational factors:
 Project team management: The selection criteria need to be accurate for persons
involved in the project. Project Manager need to efficient in managing the
development of the whole project. It’s Project managers responsibility to assign
duties about the project according to their capability. As the project is divided
among four contractors so they need to be managed.
 Scope, Time and cost: As this project is vast in itself so, it has to be completed
within the time frame and budget. The scope needs to be clearly defined to
achieve the objective of healthcare.gov website.
 Organisation management support: Communicating upward is the concept used
here that means the progress during the project lifecycle must be communicated to
the top- level management and stakeholders. The progress report must be
submitted to senior management at defined interval of time. Communication gap
proves to be one of the factors of the project failure.
 Manage change management: During the development phase, changes may be
in term of objectives or team member, it need to be managed. Change
management plan need to define clearly. Changes need to be documented properly
for further reference in future. Every single person involved in the project is an
important assets so replacement or removal of the person leads to loss of
information.
 Quality Assurance: delivering a good quality end product to the user is objective
of the project. It is important to make sure that the project aligns with the

objective defined. Quality assurance is the responsibility of organisation, project
manager and involves regression testing needs to be done before launching the
website.
 Manage Resources: the resources utilised or required during the project
development need to be managed to avoid any situation of run out of the
resources.
 Technological Factors: this project objective is to collaborate the Health facility
with the insurance companies. Huge volume of data needs to be handled so
information security is the main consent.
 Physical factors: Assets and resources required for the project need to be maintained
and secured. Any damage or loss to these assets can affect the project progress.
Physical security is important.
4.1.2. External factors influencing the healthcare.gov website;
 Economic factors: Any changes in the existing market condition that had an influence
on the demand and supply of the services. In this case, we need to keep an eye on the
economy of United States and political decision during the project development life cycle
and the goals of the project gets deviated from its set path and its demand changes with
the time. These are the dynamic that is hard to predict But can be identified initially by
monitoring it closely.
 Natural factors: during the project development phases, we need to consider nature as
one of the factors that may affect the project. Climatic changes, earthquakes, floods,
cyclones are the environmental dangers that can hamper the resources and organisational
environment. We can only opt for the preventive measures for these risks, but we cannot
predict the intensity of the damage it may cause until it happens. This factor had an
influence on the economy of the state or the country. As it cannot be totally avoided but
preventive measures can be taken in this direction.
 Political Influence: Healthcare project is the e- government project of the Federal
government of United Nations. It will have political influence and any change in the
political scenario during this period can have detrimental effect on the project. Political
changes that had changed decision making and hence effects this project needs to be
monitored closely.
 Media and mass communication: Political interest makes this e-government project as
the topic of discussion and media projection makes a lot of concern to the project.
President of United States has proposed this project, so all eyes are fix on it. Media can
spoil the image of the project and create the situation of distrust among the residents of
America regarding this project. It also needs to be considered as risk and need to be
managed.

5. Risk Assessment:
According to the AS/ NZS 4360: 2004 Risk Management standards, Risk management
process initiates by identifying the potential risks. In this phase, the internal and external
influential factors evaluated before can help in potential risk identification that might be
occurs during the project development cycle. If the risk or uncertainty is identified, it is
helpful for project manager to access and handle, avoid or mitigate the risk effectively or
efficiently. Due to number of causes the similar e-government projects failed. We have
search online about the causes of failure for various IT disasters and concluded that it is very
important to identified and analysis the risk for project success
The risk assessment includes risk identification and risk analysis. In the following sections,
SWOT (Strength, Weakness, Opportunity, Threats) analysis technique is utilised to identify
the risks that may occur during the project development and identified risks are quantitatively
analysed using the Risk Assessment Matrix (RAM).
5.1 Risk identification:
It’s always better to start before the mis happening happens. From the beginning of project,
the risk identified is initialized and it continues throughout the lifecycle of the project. The
internal and external risk integrated with healthcare.gov have been identified and are
discussed in table 1.
Risks Description
1.Inadequate Project Planning This type of risk will be occurred if the
project manager is not able to plan the
project effectively or efficiently. The poor
project planning could cause project failure.
If the PM do not have skill and knowledge
about project planning the project may be
failed.
2. Lack of coordination As the three companies are responsible for
project completion it is very important that
they can communicate with each other for
proper coordination. if there is no
coordination they are fail to take right

decisions at right time and if there is any
changing requirement they are not able to
do so because of lack of coordination.
3.Project complexity Healthcare.gov is combination of three
systems i.e. social security, organisation
insurance and Medicare. if the data will be
mismatch system may give error or system
functional incapability.
4. Poorly defined Scope It is very important to define the scope
statement properly and ensured that every
team member or client is clear about the
project scope. if the project scope is not
clearly defined it leads to unclear vision of
project among client or project team.
5. Schedule changes If the project requirements are continuously
changing it could affect the quality of
project
6. communication Gap If the team who are working on
healthcare.gov are not following proper
communication policy, then they are not
able to report their progress status or any
other communication with seniors.
7.Political involvement White house members may try to involve in
the project which could result in delay in
decision making.
8. Issues with human resource During the project cycle if staff is
continuously changed it could results into
inefficient responsibility to the project.
Some positions may be vacant.
9.Inadequate testing It is important to test the software regularly
because there are regular changes in the
project and project manger left with no time
for testing. The effect of inadequate testing

will be seen after the launch of the project.
Table 1: Identified Risks for Healthcare.gov project
5.2 Risk Analysis:
Risk Assessment Matrix (RAM) that is one of known quantitative methodology utilized to
analyse the identified risks for its impact on the project and probability of happening:
likelihood. Impact and likelihood are determined on the scale high, medium and low.
Risks Impact Likelihood
1.Inadequate Project
Planning
High Moderate
2.Lack of coordination Moderate Low
3.Project complexity High High
4. Poorly defined scope High High
5. Schedule changes High High
6. communication Gap Moderate Moderate
7.Political involvement Moderate Low
8. Issues with human
resource
High High
9.Inadequate testing High High
6. Risk Evaluation:
After the assessment of risk, the next step will be evaluating the risk. In this process, the
condition that could cause the risk is identified and the prioritization of risk is done to deal
with the specific type of the risk. Moreover, the risk prioritization also helps in deciding the
urgency of risk handling.
High Priority Risks are scaled as 1 that needs urgent attention and the chances of occurrence
is more , followed by 2 as moderate risks that can be identified and handled and 3 defines the
low priority which means that either the probability is negligible or its likelihood can be
avoided
Risks Risk priority Moment of risk
1. Inadequate Project 1 Project manager has lack of skills or

Planning knowledge.
2.Lack of coordination 2 Poor communication between all three
companies.
3.Project complexity 1 System inadequate functionality.
4. Poorly defined scope 3 Project manager has no managerial skills.
5. Schedule changes 2 This risk arises if PM do not know how to
handle the changes.
6. communication Gap 2 Project team resistance
7.Political involvement 3 White house member’s involvement.
8. Issues with human
resource
1 Vacant positions in white house.
9.Inadequate testing 1 No time for regular testing during the changes
in project cycle.

7. Risk register:
For identified the risks we can follow a treatment method, this process is called risk register.
The last step in risk management process is risk register in which all suitable strategies and
action are framed to minimising and mitigation the risk impact. These risks are already
accessed and analyzed in the previous steps. For successful delivery of project, it is very
important to handle the identified risk in an efficient and effective way. In the following
table, the risk register entries are defined-
Risks Treatmen
t
type
Likelihoo
d
rating
Mitigation
strategies
Impact
rating
Priorit
y
Risk
ratin
g
1.Inadequate
Project
Planning
Accept Moderate This could be
handle by good
skills of project
manager.
High 1 High
2.Lack of
coordination
Mitigate Low This risk could
be mitigate by
proper
communication
policies.
Moderat
e
2 Low
3.Project
complexity
Accept High By making our
system efficient
for handling all
type of data we
can eliminate
this risk.
High 1 High
4. Poorly
defined scope
Mitigate High To mitig-
-ate this risk ,
the project
manager has to
plan a clear out
and in scope
statement that
High 3 High