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With the CY 2025 PFS final rule (89 FR 98132 through 98153), we established the option for eligible renewing ACOs to receive prepaid shared savings, starting with the performance year beginning on January 1, 2026 (as specified under § 425.640), to provide an additional cash flow option to ACOs with an established history of earning shared savings that will encourage their investment in activities that reduce costs for the Medicare program and improve the quality of care provided to their assigned beneficiaries
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