Case Study: HealthCare.gov achieves rapid deployment and seamless, scalable enrollment for millions with MarkLogic

CMS Speeds Time-to-Production, Creates Seamless Online Shopping Experience

After the Affordable Care Act passed, the HHS Centers for Medicare & Medicaid Services (CMS) needed a platform to enroll millions of Americans through HealthCare.gov on a compressed 18-month timeline. An initial relational-database approach failed; CMS faced large volumes of heterogeneous health and financial data from many insurers and providers and needed a secure, scalable system that could adapt quickly to policy changes.

CMS adopted MarkLogic for data consolidation, master data management and content delivery, ingesting data “as‑is” with a NoSQL document model while retaining government‑grade security, ACID transactions and HA/DR. The site launched in 18 months and quickly scaled—supporting 5,500+ transactions per second, more than eight million signups in five months, 160,000 concurrent users, >99.9% availability and sub‑0.1s response times for the vast majority of queries—enabling a seamless online shopping experience without recoding disparate data sources.

HealthCare.gov

Henry Chao

Former Deputy Chief Information Officer