Leading Healthcare Reform

The Affordable Care Act (ACA), passed in 2010, was enacted to make healthcare affordable, accessible, and high quality. But it also stirred up intense controversy and headlines as Americans wrestled with mandates for individual insurance, new taxes on high value or “Cadillac” plans, and the Government faced implementation challenges due to the complexity of an enormous law.

From the beginning, all eyes were on the White House and federal agencies charged with rolling out the new program. Hundreds of Booz Allen experts—working with multiple government agencies—deployed to meet the mission.

Although the ACA is widely credited with ushering in U.S. health reform, health reform actually started at the very beginning of the Obama administration. The American Recovery and Reinvestment Act (ARRA) and its Health Information Technology for Economic and Clinical Health (HITECH) provisions passed in 2009 laid the foundation for the “pay for value” movement that underlies the payment reform provisions of the ACA. And reform continues with the passage of the Medicare Access and CHIP Reauthorization Act of 2015. Combined, these laws regulations meant changes for many agencies that Booz Allen supports, including:

• The Office of the National Coordinator for Health Information Technology (ONC)
• The Centers for Medicare & Medicaid Services (CMS)
  
• The Agency for Healthcare Research and Quality (AHRQ)
  
• The Internal Revenue Service (IRS)
  
• The Office of Personnel Management (OPM)
  

“Booz Allen’s work is helping to change and shape the future of healthcare in our country,” says Executive Vice President Kristine Martin Anderson, who leads the firm’s civil health business. “The expertise and skill our people bring is key to our position as an essential partner and market integrator for health care reform across our civil clients.”

Let’s take a look at highlights from a few of our engagements.

ONC was charged with getting the U.S. healthcare system out of paper records and HITECH provided incentives to the private sector to make change more quickly. Booz Allen provided technical assistance, training, and a learning community for the organizations that were fanning across the country to implement and use electronic health records (EHR). Booz Allen facilitated conversations among 17 “Beacon Communities” that had made progress in the development of EHRs and health information exchange—to identify best practices. We also developed and offered training for 62 ONC-funded Regional Extension Centers as they helped 100,000 primary care providers implement EHRs.

Booz Allen also was selected to work with CMS and other federal agencies to support state governments, and insurers as they built and now operate Health Insurance Marketplaces—a complex system of systems providing individuals and small business employees with access to affordable health insurance coverage. Examples of our work include:

• Designing processes to determine consumer eligibility for health insurance and subsidies on the Marketplace
  
• Assisting CMS on oversight that included compliance review of health insurance plans, and training of agents, brokers, and customer service representatives
  
• Providing technology support, appeals strategy and operations, and state Marketplace technical assistance.
  

During the third open enrollment season, 12.7 million people signed up for Marketplace coverage. Our capstone achievement was CMS’ award to Booz Allen of a $188 million contract to serve as the Marketplace System Integrator, tasked with making sure all critical components of the Marketplace’s technology systems, internal operations, and policy objectives align.

Reforms also hit the IRS. The 2015 tax season marked the first time subsidy payments for the millions of newly insured would be reconciled by the IRS. Booz Allen worked with six business divisions across the IRS—and nearly every vendor at the agency to build a quick and easy IT tool to help taxpayers apply the new rules. And it had to be perfect.

We successfully designed, developed, and introduced an entirely new system: the ACA Verification System (AVS). Booz Allen’s team “broke down the [906-page] legislation,” says Senior Associate Yolanda McMillian. “Then, once we had the requirements in plain English, we worked with our technical staff to interpret and translate them into code.” AVS interfaced with old and new systems to process more than 150 million tax returns during 2015 without a single error!

In all, our work touched five agencies and almost every aspect of the health reform platform. This work demonstrates how Booz Allen builds multi-disciplinary teams, bringing together the right people with the needed expertise to solve challenges across markets and agencies.

Download the full PDF of the 2016 Impact Report.