This is more of a personal note on the scramble to get the Exchanges up and running which then ran into a brick wall of Healthcare.gov not working at all last year.
Last year, I spent thirty one of the thirty six hours before go-live either at work or online at home. My major challenge was to get the web directories up and running so that they would reflect the accurate at that moment network that we were offering.
We had “finalized” our networks a week before hand, and the web developpers were still working on a long term solution to reflect the networks as it was a massive discontinuity from our previous practices. Previously, we had embraced big, broad, everybody who wants to get in can get in networks. The Exchanges were narrow networks with significant targetting. The “final” networks were not really final, as we received a contract amendment to opt-in to Mayhew Narrow at Medicare + a smidge from a two hospital chain and its 300 docs at 8:30pm the night before go-live. Since the long term solution was not in place, I had an ad-hoc solution that was ‘good enough’ to work and that required a four hour rebuild process. I launched my final good to go web directory at 2:30AM
This year, the web directories entered the production stream three weeks ago. One doc had the nerve to die on us, so we had to remove her, and another practice bought out a four doc cardiology practice so we had to add them, but that is the normal churn of networks. It is routine.
I received one call from a co-worker this weekend. She wanted to know where the financial attribution schema for SNP was stored. This year, I went to a wedding where the brides were beautiful. I refereed a championship game where I loved that it was 31 and snowing instead of 33 and raining. I went to the birthday party of a friend’s daughter.
Last year, I had a 110 hour week .
This year, it is business as usual.