Poor governance and a reliance on contractors who were good at procurement but not as strong in technology were two of the many factors that contributed to the botched rollout of Healthcare.gov and the ongoing issues in many states.

During a panel discussion at the National Health Insurance Exchange Summit in Washington, D.C., a group of technology experts reached that consensus, while acknowledging the exchanges are a “grand experiment and we are only in the second inning,” said Daniel Schuyler, director at Leavitt Partners and former director of technology of the Utah Health Insurance Exchange.

Many states spent millions of dollars on their state-run exchanges, only to have to rebuild or retrench them, said Chini Krishnan, CEO and co-founder of GetInsured. For example, Maryland spent $261 million on a website that is still not fully functioning.

In some states that are running their own exchanges, including Oregon, contracts focused on companies that had contract expertise and not domain expertise, resulting in a lack of unified IT responsibility, Krishnan said. Many states relied on multiple vendors, which makes a unified approach all the more difficult, he added.

John McDonald of InfoSys said the amount of money thrown at a project matters less than good governance at the outset. States needed a clear understanding of contractual terms, otherwise a lot of time is spent determining what is and what is not in the contract, he said.

Don Garlitz, executive director of health exchange solutions at bswift, also agreed that it doesn’t matter how much money you throw at a project as complex as the exchanges. “The bottom line is there is a lot that needs to be done,” he said.

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