Cloud a ‘game-changer’ for health insurance marketplace
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When California’s health insurance marketplace migrated to the cloud, it cut costs, improved consumer experience and gained the ability to scale to demand.
Following the 2010 passage of the Affordable Care Act, California set up a state-based health insurance exchange to allow its 39 million residents to comparison-shop plans and enroll in coverage.
The marketplace, Covered California, originally deployed an on-premises system called the California Healthcare Eligibility, Enrollment and Retention System, or CalHEERS, the portal through which Californians determine plan eligibility, locate certified insurance agents and complete health care enrollment.
CalHEERS once resided on two “aging” in-state data centers, but now the complex system supporting 14 million enrollments now runs in the cloud, resulting in decreased costs, an improved consumer experience and the ability to scale to demand, according to Karen Johnson, Covered California’s chief deputy executive director.
“What I wanted to avoid was the looming capital expenditures of hardware and software” that would have been required to keep CalHEERS running on data centers, Johnson said, speaking at Amazon Web Services’ re:Invent in Las Vegas Tuesday. “Also, with the legacy system, you’re incurring more technical debt.”
Now that the marketplace is in the cloud, she said, “you can scale up and achieve efficiency and speed.” CalHEERS was able to meet the spikes of up to 400,000 simultaneous users that occurred during the COVID-19 pandemic and after the American Rescue Plan Act was signed. Such scalability wasn’t possible with the on-premises system, which had to operate at full capacity—and high cost—at all times in order to meet the heavy traffic demands during open enrollment.
With CalHEERS in the cloud, “we were able to handle 100 million transactions in a given day without any serious or critical issues,” Johnson said, adding that performance of the portal improved “by 200%” in its first year in the cloud, despite a 20% increase in total enrollments.
With the cloud migration complete, Johnson said Covered California is moving to “more of a cloud modernization,” building on the infrastructure it developed with its commercial partners. The portal now has a consistent user experience, and Johnson said it will use cost savings achieved through the cloud migration to add more features.
“We’re refining the digital infrastructure, and we’re going to be better prepared and capable of [managing] what’s coming next, whatever next might be,” Johnson said. “Without these technical strides, we would not be able to meet the demands and deliver efficiently our services.”
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