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As the commenters noted, for the 2023 performance year, this resulted in some Shared Savings Program ACOs effectively not being scored on the MCC measure and having greater weight placed on the remaining measures in the APP quality measure set because when the denominator for a quality measure is reduced to zero, the measure is removed from the performance category score

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2017 doi: 10.1016/j.cellsig.2017.10.014