Ironically, because of prior problems with technology proj- ects, the Oregon legislature required the state to hire a quality assurance contractor. Maximus Corporation, to oversee the project. From the project's start. Maximus reported significant problems involving divided control, lack of clear requirements. inappropriate contracting methodology. lack of project plan- ning, and lack of progress. It is unclear to whom those reports were delivered or what was done with them. In January 2013 when the head of the OHA project received another negative re- port in a long string of such negative reports, she threatened to withhold Maximus' payment. 24 Alas, when, in January 2013. The Oregonian asked Rocky King, the director of Cover Oregon, whether the system would work, he responded. "I haven't the foggiest idea. Sadly, when the fog cleared, the exchange failed. In March 2015. Cover Oregon was shuttered Questions: 1- Summarize the purpose and intended benefits of a healthcare exchange 2- Explain why a healthcare exchange requires an interorganizational information system 3- Using knowledge from this chapter, summarize the challenges of developing and implementing an interorganizational information system 4- Explain what you believe are the reasons for the Access CT success CASE STUDY 7 A Tale of Two Interorganizational IS The Affordable Care Act (also known as Obamacare) requires simplify and partially automate the selection process. Exchanges the creation of healthcare exchanges that necessitate the devel. also promote fair competition among health insurers. opment of Interorganizational information systems. States were Besides simplifying the selection of health insurance, an encouraged to set up exchanges for their own residents, but if other goal for exchanges is to help consumers navigate the com- they elected not to do so, the states' residents could use an ex: plex array of governmental assistance options and possibilities. change developed by the federal government. About half of the Depending on income, family size, and other circumstances, states decided to use the federal exchange. The remainder devel some consumers are entitled to Medicare and a variety of other oped their own exchanges and supporting information sys governmental programs. Thus, when using an exchange, a con tems). These many parallel development projects give us a sumer provides personal data about income and family situa- unique opportunity to learn from the experience of similar proje tion, and the exchange uses automation to contact various go ects that had. In some cases, very different outcomes. ernmental agencies to determine that consumer's eligibility, Consider, for example. Connecticut and Oregon. The state of Given this determination, the exchange then offers Insurance Connecticut created an exchange named Access CT. It was deliv products appropriate to that particular consumer's situation. ered on time and on budget and has been such a success that the Exchanges are supposed to pay for themselves by charging a state of Maryland stopped developing its own system and modest fce to insurers. censed the Access CT solution instead." Other states are consid Figure 7-23 shows some of the organizations involved in a ering licensing Access CT as well. On the other hand, the state of healthcare exchange. Clearly, an interorganizational informa- Oregon created an exchange named Cover Onyon that was a tion system is needed. As you know from this chapter, such proj complete and utter failure. Cover Oregon was never operable de ects are difficult to develop and manage, and it is not surprising spite costing more than $248 million in ULS and Oregon tax dol that some states failed. lars. In May 2014, the US, attorney's office in Portland opened a grand jury investigation into the project.12 Access CT Why were there such different outcomes? The two states started their projects about the same time, they had the same Access CT is a quasi-public corporation. The chairman of the scope and goals, they began with about the same funding (Cover board is Connecticut's Lieutenant Governor. Nancy Wyman, Oregon eventually spent nearly twice as much as Access CT). who set out in the summer of 2012 to find an appropriate CEO and they had the same required finish date. There is no substan. A nationwide searched identified 74 candidates, and in July tial difference in the population of the two states: Connecticut 2012, the Connecticut governor hired Kevin Counthan. has about 3.5 million people and Oregon about 3.9 million. Counhan had more than 30 years of experience working in What caused the different outcomes? the insurance Industry and had been a key player in the develop ment of the Massachusetts healthcare system (widely regarded What Is a Healthcare Exchange? as the model for Obamacare). Most recently, he had been the president of a private health exchange in California." To begin, a healthcare exchange is an online store that offers Counihan holds a master's degree in marketing and it health Insurance products to individuals and small businesses. shows. As soon as he was hired, he began a series of press confer- Choosing medical Insurance is a complex process with many dif- ences to explain the nature and goals of the project to the public. ferent levels of coverage and costs and selecting the right policy Within a few months. Counihan hired senior staff with deep ex- is difficult and confusing for most people. Exchanges are thus perience in insurance, including im Wadleigh. Chief Information created not only to offer medical Insurance policies, but also to Officer. Wadleigh had been director of application developinent Rent projects give us a sumer provides personal data income and family opportunity to learn from the experimentar per and the changes to control acts that had in some wery different outcomes chladies to determine that comer's Consider. For example. Conecticut andre. The state of this determination, the exchange the offers Insurance Connecticut created an exchange someone was del products appropriate to that particular consumer's station ered on time and en bland has been such as that the changes supposed to pay for them by changing a state of Maryland topped developing the owner and modeste to. med the Accessolution. Other states.com Pipare 7-23 shows some of the nations involved in a ringming Access Caswel. On the other hand, the state of healthcare exchange Cars an internal informa Organ created an exchanged were that winst is eeded. As you know from this chapter och pro complete and utterfl.Cover Crepe water operate de acts are difficult to develop and manage and it's not surprising pilte costing me than $245 milioni and Oregon del that was aled. lars in May 2014. the Sworney's office in Portland opened a grandwet into the project Access CT Why were there achterte The two states started their profects about the same time, they had the same Access CT ha qui public corporation. The chairman of the ape and goals they began with about the same funding Cour board Connecticuttenant Genere, Nancy Wyman Oregon ventally ent nearly twice as much as com shoot in the summer of 2012 to find an appropriate and they had the required finish dute. There is not deached entified candidates and in July al difference in the population of the two state Conection 2012. the Connection ere hired Kevin Counter has about 1.5 million people and Orego about 19 million Curhan had more than 20 years of experience working is What caused the different outcomes therance Industry had been a player in the develop ment of the Mathealthcare system (widely regarded What Is a Healthcare Exchange? as the model for Chance Most recently he had been the presidente arte health change in Calon To begin ahale exchanges in cline tore that offe Coundhan holder degree in marting and health insurance prodotto individual and intell bis shows. Momshe washid, he began represcinder Chiny medical insurance is a complexes with me to explain the nature and all the project to the public. femtes of coverage and costs and selecting the right policy Within a few months Counhan hired serial with dep felt and confusing the most people changes in this perience incending in Wadleigh. Ini created not only to offer medical insurance policies, but also to Off Wadleigh had been director of application development State A hoor Individuals and FIGURE 7-23 Healthcare Exchange Interorganisational IS Agy for Cian healthier. Wade primary operation October Indian culty towe en was to hired minage and contracted that it was for the news of the allure to reach him, wopthechan Wobute and supporting backend cadeandt any consume dhe or was a hunden manage the main of the change Information of the projecte de delegate any nected ystem datote that role By June 2012. Acces CT had ved at plaande According to in from the out the project ganacheconnector to develop the delly Sterfered from divided direction, we aquadep 2012. a selected DelomeCouling LLP. At the time. Wadeligh den optimal.com.but the exchange information atd. With only 12 months and the Exchange sy was to be developed by different way Com Band Analys Indud Sale FIGURE 23 Healthcare Exchange internationalis few Ang for CHINA.shahrten Wadig rygertal Oberland its rely to believe nimmt was to hire and manage antide contacted that took for the war the filetomach him. In velop the change and supporting and code and to come the was a hands manage the implementation of the change information manager of the projecte de lege nyested oficial to take that me. Hy June 2013. Ane Chaded project plan dhe According to starom them, the pasca for the center in depth ly September fered from divided direction Cowels que 2012, it selected belowing ? At the time, Walleigh demt corporation bec Chat the exchange information atd. With only 12 months and the changes were was to be discloped by different fook forwant to beginning tar work with the immediately path they endle the two ades That samme. In an interview on July 11. licet pred into bailes and held diep die about project porter ased CH Co. Can you partit denen merequirement. The dilemes mule is changing mp"This studento podem Incontro de And silly the end of the federally made drie Turther unice CT. ORA dalt hire a super Access CT had corolled 301 301 Connecticut resident and contractor for the project, but instead decided to take an Connecticut had become a model for state-run changes the role in the ware devet. Tortunately, the oted hiphopkeyar team and hal aneaky hits Cover Oregon ingandeping qualified Adid in the rise professional ware development company crema Theostome positive in Murige ware components of the show for y 5250 milion, the change was clearly and the work two dropped out the last minute and the winner by de exchange's board of directos decided to development and fault Onde Corporate became in we were willine the fineral exchange instead. Alher this decision, the doo Oracle was able to me Oregan gure hired an independent company Descricher than forsiderable at Corporation to investigate the cases this decl. specific prion. Late when em dloped. Once we paid inlike in Connecticutter Oregon's OK to millions de fer change order on that other elected official was directly involved in the fact time and table wiped to do much In January 2014. the stated that held only become of programming but the real experience with aware of the sur le tebe *The site was to have Orade and laced both developed an Ironically, because of prior problems with technology proj- ects, the Oregon legislature required the state to hire a quality assurance contractor. Maximus Corporation, to oversee the project. From the project's start. Maximus reported significant problems involving divided control. lack of clear requirements. inappropriate contracting methodology, lack of project plan- ning, and lack of progress. It is unclear to whom those reports were delivered or what was done with them. In January 2013. when the head of the Oua pin