Following the approval of the Affordable Care Act, the U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) needed to design, build, and implement a technology platform capable of enrolling millions of Americans in new healthcare plans. CMS attempted to achieve this with a relational database, but the project failed, so CMS selected MarkLogic to meet its 18-month deadline.
HealthCare.gov has been running on MarkLogic for years as the largest personal data integration project in the government’s history. And, CMS was able to easily migrate the solution to the AWS cloud to support its Cloud First strategy ̶ ensuring agility and scalability to meet future needs.
Add in an ever-changing and volatile, policy-driven environment into an IT infrastructure challenge, and you know you need something powerful yet agile to meet changing requirements. With the MarkLogic database, we were able to accomplish CMS goals in just months. To date, the CMS has over 11 million subscribers.
Henry Chao
Former Deputy CIO at CMS at HealthCare.gov
MarkLogic ingests data as is and adapts to modifications as new data sources are added, and as policies or regulations change. With MarkLogic, CMS didn’t have to sacrifice any features expected from a traditional database, such as government-grade security, ACID transactions, and HA/DR. Additionally, CMS could also take advantage of a NoSQL document model that handles heterogeneous and unstructured data, and scales easily — which is essential, particularly during open enrollment.
CMS launched HealthCare.gov within 18 months. In under five months post-launch, MarkLogic supported 5,500+ transactions per second to help over eight million people sign up for health insurance.
MarkLogic has supported 160,000 concurrent users and delivered over 99.9% availability. Over 99.99% of queries have logged response times of less than 0.1 seconds, without any data loss or inconsistency.
CMS can now integrate data as is, so there was no need to recode data from multiple states, government agencies, and health plan providers. This made it easy to provide competitive healthcare options to site users.