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Archive for June, 2014

VA, IRS, ACA, Insider Threat: Defining the Problem, and Some Ideas

Wednesday, June 4th, 2014

I’ve been taking some time the past 5-6 weeks to think about some of the big issues that are dominating the national news and to try to come up with some ideas that address these challenges.

Veterans Administration healthcare delivery

IRS tax audits

The Affordable Care Act’s implementation

Insider threats like Ft. Hood, the Washington Navy Yard and law enforcement tragedies like Newtown and Santa Barbara

Like you I have read the articles listing possible new leaders for each of these initiatives, and most recently Peggy Noonan’s Opinion piece in Saturday’s Wall Street Journal.  I think she was on to something at the end of her comments:

“The current lack of serious and effective management damages the progressive project because it presents that project as utterly cynical.  It presents progressives as people who really care.  If the cared, they’d oversee.  They’d make sure it works when the rubber hits the road.  They’d make sure the thing they supposedly want to happen (first-rate treatment for vets, for instance) happens.”

My idea has four parts.

1. Leadership and Expertise: Leaders do three things, to my mind:

  1. Define the objectives for an enterprise and how to get there, informed by the experts in their market and their business;
  2. Understand what resources and enablers are required to accomplish the objectives;
  3. Get the resources.

Many wonderful people can serve that role at the VA or the IRA or ACA. What I am most interested in seeing is who is put into the number 2 or 3 role…..the Chief Operating Officer role that converts the vision, strategy, plans, objectives and resources into progress and accomplishments. I want to see people like Steve Rohleder, Mike Salvino, Mike Burwell and Sam Hazen in the number 2 or 3 jobs. I bet you don’t know any of them. These are industry experts who should be running the operations and service delivery aspects of the VA, IRS, ACA, etc..

The VA is not about honoring our military.  It IS the largest healthcare delivery system in the world.  The IRS is not about tax policy.  It is the largest accounting and audit operation in the world. Let’s match the necessary expertise with the objective of each of these situations.

Sam Hazen is President-Operations for Hospital Corporation of America.  Mike Burwell is Transformation Leader at PwC,the largest tax accounting and audit firm, and previously was the firm’s US Chief Operations Officer.  Mike Salvino is Accenture’s Group Chief Executive-Operations, and was previously the head of the firm’s Business Process Outsourcing practice.  Steve Rohleder is Accenture’s Group Chief Executive-Health and Public Service.  His previous job was as Accenture’s Chief Operations Officer.  These guys have expertise in making sure operations deliver services, efficiently and effectively.  Give them the funds and authority, and they are the kinds of executives who can make things get better in huge, complex, partnered situations.

2. Scale, Complexity and Elasticity: I hear lots of folks talking about how the new insider threat/continuous monitoring requirements are so complex and the numbers of people to be monitored so huge that the required new requirements cannot be implemented. I agree. Scale alone……….. in the VA, the IRS, the ACA, counter-terrorism/counter-intelligence/threat monitoring………makes taking on these initiatives in one big bite likely doomed to failure for an extended period of time, even with expert industry and operational leadership.What to do? Break the huge problem down into “doable” pieces. Make sure those pieces are representative of the larger initiative, and that the operational and service delivery processes and capabilities developed for a piece are replicable to other pieces of the problem and scalable to handle the entire load at the appropriate time.Prioritize the components of the problem, and focus on them. Use surges, as we do in the military. I am a big fan of taking the problem out of its context and to the experts, versus bringing the experts to the problem in the context in which it resides. A couple of examples. Go fix the Phoenix VA with people, skills, processes, operations that get that one operation properly providing services to veterans. Do it in a way that can be laid onto other VA operations, as well as scaled to the larger challenge over time. I bet there are too few doctors, specialists and patient assistants to meet the demand in the short term. So let the vets with the most serious healthcare issues go to private practitioners, or to large healthcare systems, that may well be a piece of the puzzle for at least the medium term. That’s the elasticity we see in many industries when there is a surge in demand. Outsource the processing of tax returns for all individual and join returns with incomes over a certain amount, or all global corporations, to a tax accounting and audit expert firm. With the concentration of wealth in our country, this would be a very small number of returns…..that would represent the large majority (80%+) of tax revenues. For the intelligence community, there are too many people and too many potential threats to our security to adequately cover them all. And if we try, we spread our resources so thinly that we don’t do an adequate job of predicting any threats. I bet there are ten or twelve countries or organizations that are the most likely source of 80%+ of the threats to the US. Prioritize and focus our best resources….all of them if we have to….on those, so we minimize the probability of strategic surprise. And then be honest with the American people, and make sure we understand that in today’s world there WILL be terrorist attacks, regardless of what we do.

3. Give them the necessary tools, and hold people responsible and accountable: For outcomes, and for their actions. If the Phoenix VA fudged the wait times to get their bonuses, fire them all. Now. If the Santa Barbara cops did not look at the YouTube videos or check firearms records before they dismissed Elliot Rogers as a threat, that is just not acceptable. Fire them all. Now. In just about every mass murder and terrorism case in the past few years……the Times Square bomber, Ft Hood, Newtown, the Washington Navy Yard…..a failure to do basic police investigative work preceded the disaster. There is plenty of technology and data available for every one of these situations…..mental health records, healthcare services delivery, accounting and audit, background checks/security clearances/insider threats/continuous monitoring, etc. Most of the time, when we dig down into why we didn’t know what we could have known, it turns out that the people who have the job, responsibility and authority did not have the required skills or training and/or did not do the basic processes that would have informed them of the potential threat so that they could have investigated further and mitigated the threat before it because one more disaster.

4. Provide the Resources: That’s what our government is responsible to do.

Tell us what you think needs to be done.  Send me a note with your thoughts, and I’ll share your ideas and recommendations with our readers.  You can reach me at




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