The final Medicare Shared Savings/ACO rule is a lot more flexible than what was initially proposed, showing that public comment certainly swayed officials at the Centers for Medicare and Medicaid Services.

"CMS decided it was more important to get broader participation in this program," says Chas Roades, chief research officer at The Advisory Board Company, a research and consulting firm. "They clearly were concerned with all the comment they got from the provider community that the requirements were too onerous."

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