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Tuesday Short Cuts

Health and Human Services Secretary Sylvia M. Burwell announced today $169 million in Affordable Care Act funding to 266 new health center sites in 46 states, the District of Columbia and Puerto Rico for the delivery of comprehensive primary health care services in communities that need them most. These new health center sites are projected to increase access to health care services for over 1.2 million patients. These awards build on the $101 million awarded to 164 new health center sites in May 2015.

Super-utilizers are the frequent fliers of the health care system, whose serious illnesses send them to the hospital multiple times every year and cost the system hundreds of thousands of dollars annually. Figuring out how best to address these patients’ needs and reduce their financial impact on the health care system is a subject of intense interest among policymakers. Now a new study has found that, in contrast to the notion that “once a super-utilizer, always a super-utilizer,” many patients who use health care services intensely do so for a relatively brief period of time.

CMS is postponing the release of its preliminary risk corridor program results, the agency said Friday (Aug. 7), in order to further validate the data after finding a “significant number of discrepancies.” The information was slated for publication on Thursday (Aug. 14).

“We will provide further information when the risk corridors data is accurate, complete, and validated,” CMS said. “If CMS determines that an issuer must resubmit its risk corridors data, CMS will work with the issuer to do so."

HHS will talk this week with potential bidders about a $150,000 grant opportunity designed to expand cybersecurity information sharing, and the department plans to make awards to one or two bidders, depending on the proposals.

The grant notice published last month by the agency cites an executive order that President Obama signed in February, which called for industry to establish new information-sharing and analysis organizations, or ISAOs, to help businesses large and small address growing digital risks.

The federally facilitated marketplace lacks the internal controls to verify that enrollees are eligible for subsidies under the Affordable Care Act, the second such finding by the HHS Office of Inspector General in as many months. In June, another OIG report said the federal exchange was unable to ensure $2.8 billion in advance premium tax credits and cost-sharing reductions were correctly spent.

About 1.8 million households that got financial help for health insurance under President Barack Obama's law now have issues with their tax returns that could jeopardize their subsidies next year. Administration officials say those taxpayers will have to act quickly.

"There's still time, but people need to take action soon," said Lori Lodes, communications director for the Centers for Medicare and Medicaid Services, which runs HealthCare.gov.

Six years later, the harsh reality is coming into focus: The mandate's primary impact will be to compel low-income households to buy bronze coverage with deductibles of up to $6,850 per adult that are well beyond their capacity to afford. Because any semi-serious health issue will torpedo their finances long before ObamaCare begins to pay the bills, this situation raises a question of whether it is even ethical to threaten them with a mandate penalty.

With support from the Robert Wood Johnson Foundation (RWJF), the Urban Institute is undertaking a comprehensive monitoring and tracking project to examine the implementation and effects of the Patient Protection and Affordable Care Act of 2010 (ACA). The project began in May 2011 and will take place over several years. The Urban Institute will document changes to the implementation of national health reform to help states, researchers and policymakers learn from the process as it unfolds. Reports that have been prepared as part of this ongoing project can be found at www.rwjf.org and www.healthpolicycenter.org. The quantitative component of the project is producing analyses of the effects of the ACA on coverage, health expenditures, affordability, access and premiums in the states and nationally.