Developing reliable backend operations and public-facing access to HealthCare.gov

Agency

Centers for Medicare & Medicaid Services (CMS)

As the prime contractor for the Centers for Medicare & Medicaid Services Website Development Support (CMS WDS) program since 2014, Ad Hoc is responsible for numerous aspects of HealthCare.gov, including program management and oversight of the public-facing website, back-end performance, and technical leadership for the entire program.

Our team is focused on helping CMS provide consumers with a stable, fast, and secure experience for this most critical of digital services: enrolling in healthcare.

The challenge

Once the HealthCare.gov rescue team, including Ad Hoc’s two co-founders, stabilized the site after the initial launch failure, Ad Hoc was brought on to help CMS provide efficient and effective digital service delivery for millions of Americans wanting to compare healthcare plans, find support from a local expert, and ultimately sign up for health coverage.

At HealthCare.gov, Ad Hoc is responsible for:

  • Discovery and requirements gathering
  • Agile development
  • Design, user experience, and usability research
  • DevOps, documentation support, security support, analytics and metrics, and continuous integration/deployment
  • Section 508 compliance, remediation, and reporting

What we did

By applying techniques proven in consumer technology to the challenges of public services, Ad Hoc implemented an infrastructure that reduces costs for our partners at CMS, and we’ve continued to deprecate legacy application processes. We’ve also helped build an authentication process that is integrated across the HealthCare.gov marketplaces.

Tools and services

Part of developing HealthCare.gov has included building various components that serve people’s needs while performing efficiently on the backend, not draining resources, and remaining consistently stable. Some of the more heavily used tools on the site include:

Marketplace API

This API powers HealthCare.gov and allows third-party services to develop applications so users can find and evaluate health care insurance plans, providers, and coverage information on the marketplace.

Window Shop

Allows people to browse qualified health plans for individuals and small business employers without having to apply for coverage first, creating a user experience that matches consumer sites while reducing the processing load on HealthCare.gov’s infrastructure. It includes Decision Support Integration: a suite of features that shows people if their provider or prescription is covered and their estimated yearly cost.

Find Local Help

An intuitive, location-based search tool that helps people find a nearby expert who can assist them in applying for and enrolling in coverage.

Design System

Shared front-end components and styles that provide a consistent, performant, and accessible interface for people using HealthCare.gov. Engineering teams across CMS can use these components in a plug-and-play manner and receive automatic updates and improvements.

Our team has helped CMS streamline the user journey, and now the website allows more people to complete their applications faster. HealthCare.gov has become a flexible site able to evolve to meet users’ changing needs and expectations. As a result, between 2019 and 2022, approximately 18.2 million people signed up or reenrolled in healthcare plans using the site.

Moving forward

We continue to support CMS as they improve the underlying tools that enable users to search, compare, and apply for the health care insurance that works best for them. Ad Hoc is proud to help CMS in growing and responding to changing technical environments and meeting people’s needs for critical digital services.