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So, thats partly it, I think

That is my entire purpose for posting this so that my friend can see how a statement like that by a rheumy can be very bad

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Additionally, to standardize timelines for payment, spending, and recoupment of prepaid shared savings, ACOs would only be eligible for prepaid shared savings if they renew or early renew to begin a new agreement period

The complexity of its administration, its high cost, and supply constraints due to limited manufacturing capabilities have all contributed to its prescription challenges (Jarosawski and Toumi, 2015)