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++ Step 3(iv): Express the lesser-of-amount from Step 3(iii) as a per capita value by dividing by the total ( beneficiary person years in the population identified in Step 2 for the applicable performance year or the benchmark year

You can see this in the chart, which shows the number of medical doctors per 1,000 people

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Accordingly, CMS would only permit ACOs that are currently participating in the Shared Savings Program, that have earned shared savings in the most recent performance year for which financial reconciliation has been completed, and that have a positive prior savings adjustment at application disposition to receive prepaid shared savings, as they have the history of success that provides CMS with a more reasoned expectation that they will earn shared savings in the future