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For the first performance year during the term of the agreement period in which the ACO receives prepaid shared savings, the ACO's prepaid shared savings multiplier is recalculated for changes in per capita shared savings or losses for the performance years used in the ( calculation of the prepaid shared savings multiplier as a result of issuance of a revised initial determination under 425.315

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doi:10.1136/tc.2010.037630 20