Before the inception of the Affordable Care Act (ACA), acquiring insurance in the individual market presented significant challenges, particularly for those without employer-sponsored health benefits. This challenge was notably felt in California, home to over 39 million residents. In 2013, more than 17 percent of Californians lacked health insurance. Thanks to the efforts of Covered California, the state’s health insurance marketplace, that figure has plummeted to a historic low of 6.5 percent, marking the most substantial reduction in uninsured rates across the United States. This remarkable progress is attributed to the dedicated staff at Covered California and their innovative deployment of Amazon Web Services (AWS).
Cloud Solutions for Healthcare Delivery
Following the enactment of the ACA, many states worked to assist their residents in obtaining health insurance. California quickly took action, becoming the first state to establish a health insurance exchange and, in collaboration with the state’s Medicaid agency, launched the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS). This portal enables eligible Californians to enroll in high-quality, affordable health insurance, allowing individuals to conveniently compare plans and secure the best options for their needs. Through CalHEERS, applicants can also verify their eligibility for financial assistance, find certified agents for enrollment support, or complete their enrollment independently.
Initially, CalHEERS operated in two on-premises data centers. In its inaugural year, it successfully helped nearly one million Californians enroll in healthcare. The number of annual users has grown steadily, with over 1.7 million Californians enrolling in health coverage each year, alongside an additional 12 million individuals using CalHEERS to check their eligibility for Medi-Cal (California’s Medicaid program) and the Children’s Health Insurance Program (CHIP). During peak enrollment periods, from October to January, the platform accommodates over 300,000 daily users and manages more than 450 terabytes of data annually.
Enhancing Efficiency and Reducing Costs
CalHEERS is a multifaceted solution, supporting over nine million active accounts and integrating with various health insurers’ enrollment systems. To harness the advantages of cloud technology, Covered California collaborated with Deloitte as its systems integrator.
After migrating to the AWS Cloud, CalHEERS saw a performance enhancement of 200 percent over the previous year, even as enrollments rose by 20 percent. The system processed 112 million transactions in a single day without any critical issues. Previously designed for peak performance, the on-premises system incurred substantial operational costs for most of the year. With cloud scalability, Covered California now optimizes computing resources, reducing unnecessary expenses. They can scale operations up during open enrollment and down afterward, leading to decreased IT costs, including hardware, software, maintenance, and energy expenditures.
“The ability to quickly adjust our computing needs without investing in physical servers has been transformative,” remarked Lisa Martin, chief deputy executive director of Covered California.
“After our initial successful open enrollment, we knew we had more to accomplish,” stated Mark Davidson, CIO of Covered California. “Our next focus was modernization, aimed at simplifying operations, enhancing performance, boosting resiliency, and cutting costs.”
Each year, the team has made strides in refining operations, simplifying systems, and improving user experiences.
“With cloud capabilities, we can scale operations efficiently while enhancing resiliency. For instance, failover times have drastically reduced from 30-40 minutes to nearly instantaneous,” added Davidson.
Positive Outcomes for Californians
Covered California strives to increase the insured population, enhance healthcare quality, lower costs, and mitigate health disparities through an innovative marketplace.
“Through Covered California and CalHEERS, countless previously uninsured individuals and families gained access to affordable healthcare for the first time, significantly enhancing their overall well-being and providing peace of mind in medical emergencies,” said Martin.
The journey with AWS continues for Covered California, evolving from cloud migration to comprehensive cloud modernization. Their efforts focus on constructing a robust digital infrastructure ready for future challenges—whatever they may be.
“Overall, Covered California has profoundly impacted the residents of California, enhancing access to healthcare and improving the quality of life. Through CalHEERS, the organization has showcased how technology can facilitate access to coverage and reduce uninsured rates,” remarked Davidson.
If you’re participating in re:Invent 2023, either in person or virtually, be sure to attend the session titled “Empowering Citizens Through Digital Innovation” to learn about Covered California’s initiatives. For additional insights into how government agencies leverage AWS to better serve their constituents, visit the AWS Cloud for State and Local Governments hub. Additionally, you can explore the authority on this topic at CHVNCI. For a helpful resource on making the most of your first day, check out this Reddit thread.
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