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In 2010, the U.S. Federal government passed the Affordable Care Act (ACA) – also known as the Patient Protection and Affordable Care Act (PPACA) – as part of health care reform. One of the central provisions called for the creation of health insurance exchanges in each state and at the federal level. Washington State created its own official ACA-compliant health insurance benefit exchange, the Washington Health Benefit Exchange. The Exchange is responsible for the operation of Washington Healthplanfinder™, an easily accessible, online marketplace for individuals, families, and small businesses to find, compare, and enroll in Qualified Health Plans and Washington Apple Health (Medicaid). Since going live in October 2013, the exchange has enrolled 1.8 million people.
Surveys by the Exchange have found that Washington Healthplanfinder is the most used channel in the state for accessing information and enrolling in health insurance. While the marketplace is a year-round resource, the most critical time is during the open enrollment period, from November 1 through January 31. During this three-month time period, a large number of people visit the site to enroll or renew their health coverage. This traffic spike far exceeds the 100,000-to-200,000 average site visits per month the rest of the year to renew or update their information or plans. At the same time, the Medicaid portion of the site is accessed year round.
According to the Washington Health Benefit Exchange (WAHBE) Chief Information Officer, the Exchange’s goals are similar to those of other sites enabling a complex process: ensure security, reliability and high levels of performance at all times. Adds the Security Officer of the Exchange, it is important to detect good traffic from bad at all times. But this becomes more challenging during the open enrollment period with such a traffic volume increase. “Any adverse impact to our site could easily make news headlines,” continues the CIO.
The Washington Health Benefit Exchange needed to meet three key requirements to support its goal of creating the best state-based health insurance marketplace in the country:
Based on the recommendation of the Exchange’s Systems Integrator and the knowledge of how other government agencies were addressing security, performance, and other important website considerations, Akamai was chosen. “Akamai’s support of other public sector agencies – including the federally facilitated health exchange – and its reputation across many industries were key factors in selecting Akamai,” explains the WAHBE CIO.
While the state has targeted enrollment numbers, there is no way to translate that into expected site traffic at any given time. To be prepared for unpredictable spike levels, it takes advantage of Akamai Dynamic Site Accelerator (DSA) Secure. In just a 60-day period, Akamai DSA Secure offloaded 70% of web content delivery and 100% of DNS requests. For the six-month period between January and June 2016, over 2.2 million people visited the Healthplanfinder website on average each month. During the same period, the online health insurance marketplace application was available 99.99% of the time. As the WAHBE Security Officer explains, “The uptime and reliability enabled by Akamai has helped the Exchange ensure Healthplanfinder’s availability to its users.”
WAHBE users have experienced the performance improvement that comes with DSA. In a 30-day period, for example, Akamai enabled WAHBE to deliver its site in under 2 seconds to over 75% of its end users. In addition, to help validate end-user experiences, Akamai provides real-time user monitoring (RUM) rather than synthetic-based testing. RUM provides visibility into the load time experienced by WAHBE’s real end users.
WAHBE also uses the Visitor Prioritization Cloudlet from Akamai to prioritize and manage access to certain services on the website year-round. WAHBE has uniquely set up the Cloudlet to help maintain productivity during maintenance and new release test periods. During maintenance times, WAHBE account workers can access and process applications while the general public is prevented from accessing the application eligibility service. Instead, the general public is sent to a branded WAHBE maintenance page hosted by Akamai.
The Exchange and marketplace are protected behind the Akamai Intelligent Platform and Kona Site Defender solution. Kona Site Defender was implemented quickly as an emergency integration by Akamai Professional Services after the Exchange received suspicious correspondences. These communications may have been associated with a notorious black hat hacking group that threatened the Exchange with a Distributed Denial of Service (DDoS) attack. Because Kona Site Defender protects the Exchange’s web application, the sites and data are safe from threats such as these. Additionally, the platform and solution are designed to absorb DDoS attacks, protecting the Exchange and marketplace from their effects.
At the same time, Akamai delivers unprecedented insight into traffic to the site both from a performance perspective and security standpoint. As a result, the Exchange has more flexibility when it comes to hosting decisions about both its corporate site and the health insurance marketplace. “Akamai’s solutions and traffic intelligence position us to effectively serve our mission,” concludes the WAHBE CIO.
Washington Healthplanfinder is an online marketplace for individuals, families and small businesses in Washington to compare and enroll in health insurance coverage and gain access to tax credits, reduced cost sharing and public programs such as Medicaid.
The Washington Health Benefit Exchange is a public-private partnership established in accordance with the Patient Protection and Affordable Care Act of 2010 (ACA) to implement a new health insurance marketplace for individuals and small businesses. The Exchange is separate from the state and governed by an independent 11-member board. For more information, visit www.wahbexchange.org.