Digital Services Innovation for the Department of Veterans Affairs
February 21, 2022
In this episode of Government Health Insights, Dr. David Shulkin, formerly the ninth secretary of the Department of Veterans Affairs and Ron Dreskin, Partner in EisnerAmper’s Health Care Services Group, speak with Robert Rasmussen, CEO and Dan Levenson, President, Agile Six, a service disabled veteran-owned full spectrum digital services company. Robert and Dan discuss their inspiration for spearheading their business, the projects they are working to offer their services to veterans and lessons learned along the way.
I will say my story starts during the first Gulf War time era. In '91, I enlisted, I was first an aircraft mechanic aboard the USS Kitty Hawk, and then I did a second tour in IT services. That's where I really learned to do some of the stuff that carried me through my career. My career carried me, after the Navy, all over the world. I did service delivery projects for telecommunications in Europe, but one of the things I always missed was the camaraderie of the service community.
So, in 2014, I found myself back here, home in the States, and looking for something, I think in the season of my life where purpose was important, and time seemed more limited. Looking for something that made a difference in the world, to do with my talents. That brought me, first, back to family programs. Having raised a couple of kids as an enlisted sailor, I really appreciated what family programs were doing to support the deployed troops. That brought me back as more of a project manager, employee of another firm. Seeing all the purpose in serving the government, and some of the things that I didn't understand or couldn't relate to, I eventually decided to launch my own firm to do things more in line with my thinking. So, I called up an old shipmate of mine, and two of my best friends. I said, "Let's do something."
Interestingly, there aren't a lot of software developers in the military. Interestingly, at least in my day, that wasn't an option. So my partners, they all had this call to serve. Two of them hadn't served in the military, and they wanted to do that in their life.
So, we got together for a weekend, locked in a cabin in Arrowhead, California. We said, "What are we going to do for the world?" We came away with improving the Veterans Administration. That's how we got started, I would say. Ran into Dan along the road, and I'll let him tell that part of his story.
dan levenson: Yeah. Thanks Robert, and Ron, Secretary Shulkin, thank you so much for having us on. As Robert mentioned, I met Robert, and I was actually serving as a federal employee at the Centers for Medicare & Medicaid Services. I started after the Affordable Care Act was passed in 2010, as a contracting officer in the 1102 job series there.
Pretty early on, that was my first experience with government. I came in with a lot of passion and purpose, and noticed a lot of misaligned incentives within the system, and really realized it's not about bad people, but really a broken system that really didn't always put users, and in this case, veterans first.
That led me to meet the US Digital Service when they were newly formed after the healthcare.gov rescue, and they really focused on outcomes, and can we bring commercial best practices to the government space? Around that time is when I met Robert who had started Agile Six just a bit ago, and was really looking to how can we serve veterans, and serve users, and put them first? It really aligned with my thought process, and some things that I was trying to do from inside the government. A few years later, after I got to know Robert a little bit, it really was an easy decision because we just were so aligned in what we think government could be, and really in putting veterans and users first. So, when I left federal service, about four years ago, I joined Robert as a partner with Agile Six.
From there, we really focused on how can we serve veterans and put them first? That led us to a lot of more novel approaches that are coming more commonplace now, really focusing on outcomes. Then again, putting the veterans first, places like va.gov, veteran-facing services.
rr: If I could jump in here, I love what Dan said there about what government can be. That's a big part of who we are. Having spent 10 years of my life in other countries, coming back, I did sense that government can be something more.
That it's the single largest funded agent of change in the world. Even if it's not perfect, there's a lot of purpose in just bumping it in the right directions. I think that's where Dan and I found common ground.
ds: Those are really the right reasons to come together the way that you have, and to help improve government. That's really what this is all about. Tell us about what your experience has been like in trying to work with VA. What was it like to get your first VA contract, and was it harder than you thought?
rr:I mentor a couple of young businesses, and one of my friends, actually this weekend, called me up after his one-year mark, and with no contracts, right? That is the rule, not the exception. It was the rule for us too. So, when I talk to people about this business, it might look both easier and harder than it is.
We had all the desire, we had all the skills, I would say we had all the confidence, but I liken federal contracting to crawling your way through a brick wall with your fingernails. Once you're through, it's a good life, it's a great place to work, but we went over 19 in the first year in terms of bids.
We leaned in hard at some really innovative stuff. We came in second place a few times, which pretty impressive, but it was a long time before we really got traction. Then, we got traction with another agency, Center for Medicaid, Medicare. Built a reputation there, and a few positive things happened at VA, and were able to come in... maybe you could say... the back door a little bit.
But it was way harder. I often reflected, had I known what I would went through second, third year, I would have gone back and changed the business plan. I wouldn't have come this direction, but knowing what I know now, I love it. There's no better place to give your gifts, talents, energy towards, but it's tough. Those first few years, I went two years without a paycheck.
ds: Robert, I just want to make sure we heard that right. Did you say that you applied 19 times and never got a contract any of those times?
rr: Absolutely. Absolutely.
ds: That's determination and perseverance. That's for sure.
rr: My partners, my early partners, I just had to keep it positive. Many times, a lot of us wanted to give up. We remember that. It's easy to think about the successes. You don't want to look back on the price you paid. But it's important getting into this business, that you realize, without government past performance and relationships, starting from scratch, it's near impossible, but you just have to learn, listen, take debriefs, take advice, travel. You never know when you're going to meet Dan Levenson. That's where things started to change for me. I was stalking him when I met him.
rr: I was one of those guys with a business card, trying to get his attention. But when I did, and this is what's most important, by then I knew, I was going to go out as me or I was going to succeed as me. I think that's what Dan would probably say was different, is I said things that were different. I no longer had the patience to say what I thought they wanted to hear. There were important things that needed to be said before I walked away. Those are the things that I think made a difference.
rd: So Dan, his sales pitch wasn't, "I'm over 19, can you help me?"
DL: No. Absolutely not. We had the, I think, good fortune of getting to know each other a little bit. As Robert mentioned, he initially jumped in as a contractor supporting agile coaching and digital transformation at CMS. Had a chance to know each other a little bit. I think, really, what stood out was, like Robert had mentioned, that really, that he stood for something, right? He wasn't afraid to be a human, to be a real person. It wasn't about putting a veneer of, "Hey, we can get all these wins." It was like, "No, this is a challenge, but I'm going to be true to who I am, or I'm not going to do this anymore." Right? "I'm not going to be willing to budge." That really resonated with me.
When I decided to jump out, it was like Robert said, it wasn't that the skills were lacking. It was really a realignment, and understanding how the space worked, but also knowing that, really, where Agile Six needed to be was this emerging civic tech space that really focused on outcomes, and focused on bringing commercial-grade talent to some of the biggest problems in government.
Some of the work that I had been doing, and a lot of my former colleagues have continued to do that work, specifically at the VA. That resulted in these, again, more novel and different types of procurements that really focused on outcomes. Our first piece of work at the VA was called va.gov modernization. It was really bringing what USDS, US Digital Service had jumped in to create, vets.gov, and really bringing that back together with va.gov, and making that a single source for veterans to get VA services. This procurement was a lot different than the ones Robert had previously, and Agile Six had previously been on. It actually entailed us going to the TAC, the contracting center in New Jersey for the VA. Within a four-hour period, basically showing how we build commercial products, and government folks acting as product owners, and different subject-matter experts, and really allowing us to show and not tell. I think once we were able to find the right customers to an extent, I think Robert, I think you'd agree, our luck changed, or our ability to really find our place at the VA changed towards that.
rr: Yeah. I would say we found our place in history. That's not something you can bet on, but we found it, like-minded people that wanted, at the root of it, the same message, which for us was, I just want a consumer experience out of my government, and I believe, and I've witnessed, and I've used government services, especially abroad, that provided consumer-level experiences.
So, we met people. That's one thing we said in some of those 19 bids, but they never landed with someone who understood what we meant, or wanted to make a bet on a little bitty shop. That one of my partners came from Amazon, and we just wanted that, and why not? The budget is there, certainly the mission, the purpose, the products that we need as citizens are there.
To get a little bit risky, to say living abroad I witnessed societies with a little bit less toxicity. A lot of it was because they believed in the government that they were building, and it was "our government", not something to be either torn down or constantly interrogated. It's us, we need to get involved and fix it.
So, meeting people on the other side of the table that would do that. As Dan said, part of it was packing up my family and moving to Baltimore, and taking a coaching role. If somebody will listen to me, I'll get involved and talk about it. Yeah, absent USDS and some of that stuff that Dan talks about, I don't think we would be here. Honestly, I wasn't ready to work someplace else that wasn't true to me, even if there was money in it.
ds: Right, this commitment to mission, and the desire to give back, and patriotism to make government work better and serve others, is something that we hear all the time on this podcast. We really salute that, and recognize how important that is. So, thank you.
You said, Robert, two other things that I thought were worth noting. One is that as much as you had hoped to get into VA, it actually began to open up once you had experience with another government agency. In this case, CMS. So, is that advice that you have, which is to diversify among agencies, because once you get in there, that may be helpful?
The second thing that you said that I'd appreciate either of you commenting on, you said, look, once you get through the brick wall, once you have some experience serving government, it's a lot more secure and you feel that you found your place, and glad that you're there. Those, I think, are two more important issues that I'd love to hear some more about.
rr: Yeah. I read a lot of books coming in, the traditional wisdom is, yes, to target two agencies, because you can't possibly understand the mission of one, much less two in a very depth way. So, I think the traditional answer would be yes, spread yourself out a little bit, but not too thin. But I think more importantly for us was to find the people within that community, regardless of what agency they're in, that will speak my language. Right? So, those 19 proposals didn't land because I was saying the wrong things to the wrong people, regardless of agency.
What is my unique value proposition to the government, first and foremost? Be true to that and understand that. Ours was pretty unique. So, I would say, yes, you got to travel, you got to get out there on the road, you got to sleep in hotels for two years. That's just the dues you pay.
But be careful with what you're saying, because all that's wasted if you find yourself into a relationship that isn't even what you're looking for. So, you come back to a place where you just become so tired of trying to sing someone else's song. You're just looking for someone that likes your tune, and that was it.
ds: Ron, any further or final questions for Dan, or for Robert?
ron dreskin: Well, this has been a very inspiring conversation. It's actually given me more impetus to get out there. I don't necessarily want to be 0 for 19, but on the other hand, I think Willie Mays was prior to becoming a Hall of Famer. So, I don't have any other questions, but I feel like I got to run out and do a few more proposals before I go home tonight.
ds: Well, it's the classic American story, right? Which is success never comes on the first try, and it's those that stay with it that ultimately succeed. Tell us, just before we wrap up here, what is the work that you're doing right now with the Department of Veteran Affairs to make government work better?
rr:Dan, do you want to take that, or shall I go first?
DL: Sure. I can go first, Robert, and then you as a veteran, of course, maybe can speak in more personal terms to some of this. We're really fortunate. Recently, we're one of the awardees on this more modern, commercial-outcome based contract vehicle called CEDAR, which is Customer Experience DevOps and Agile Releases.
That's really allowed us to double down and focus on veteran-facing services. We've really grown our team working on va.gov, and specifically building out the content management system.
Another piece of work we've recently started supporting is the check-in experience, making sure veterans at VA medical centers, it's not a burden on them, right? It's not okay to keep putting the burden onto veterans as far as accessing these services, that they've earned and put their lives on the line for.
We also support a program called the Diffusion Marketplace, which is basically a website and application to diffuse and spread best practices across VA medical centers, to clinicians, physicians.
As we all know, government at times can be caught in silos, so this has really helped to spread those good ideas and get those best practices out more broadly. Robert, I don't know if you want to speak of it, like I said, maybe more personal terms, to any of the work that we're doing?
rr: No, I think you covered it really well. I would say, just go to va.gov. I think the look and feel of va.gov has everything to do with our passions in our life. Diffusion Marketplace, it's a beautiful, it's a life-saving resource. It has great aesthetic value, but it's about our government spreading good ideas.
Even what I'm really proud of is, it's available outside of VA. What an incredible, courageous thing for the VA to do, to say, "These things save lives, and these great ideas, and take them and save lives outside of VA as well." Also, I just want to put in just a quick plug for Digital Services and USDS, and the USDS folks at VA. I see like-minded people, and all I want to do is spend the rest of my life building like-minded experiences for veterans, and for grandmas, and cousins, and uncles using CMS services.
We do some work at CDC on COVID reporting, and there's just so much important work out there, and there's funding, but the government needs better vendor communities to come in and build that, that experience that we know all of our co-patriots deserve for what they spend on this government.
ds: Well, thank you again, this has really, as Ron said, been inspirational. It's exactly what our podcast is about, and we can't thank you enough for joining us today, but also for what you're doing to make government work better. Thanks for joining us on the EisnerAmper podcast.
Transcribed by Rev.com