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End Notes

            1.  https://www.cms.gov/files/document/2021-shared-savings-program-fast-facts.pdf
            2.  https://www.cms.gov/files/document/2019cpsmdcrenrollab1.pdf
            3. https://www.cms.gov/files/document/2021-shared-savings-program-fast-facts.pdf
            4. https://www.naacos.com/assets/docs/pdf/2020/SurveyReportACO-EffectsCOVID19-
            04132020.pdf
            5. https://www.cms.gov/newsroom/press-releases/affordable-care-acts-shared-savings-
            program-continues-improve-quality-care-while-saving-medicare
            6. Ayla Ellison (Twitter) [November 3rd, 2020], 39 hospitals face maximum Medicare readmis-
            sion penalties.  Found at: https://www.beckershospitalreview.com/finance/39-hospitals-face-
            maximum-medicare-readmissions-penalties.html
            7. Ibid
            8. R. Werner, B. Coe, M. Qi, R. Konetzka [March 11, 2019], JAMA Internal Medicine, Patient Out-
            comes After Hospital Discharge to Home with Home Health Care vs to a Skilled Nursing Facili-
            ty, Home health care leads to savings despite increasing hospital readmissions.  Found at:
            https://ldi.upenn.edu/brief/patient-outcomes-after-hospital-discharge-home-home-health-
            care-vs-skilled-nursing-facility
            9. Ibid
            10. Ibid
            11. CMS, 2017 Data.  For calculation of the risk adjustment measure, see https://
            www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-
            Programs/SNF-VBP/Downloads/SNFRM-TechReportSupp-2019-.pdf
            12. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-
            Reports/Chronic-Conditions/Chartbook_Charts
            13. Ibid
            14. Ibid
            15. Beckman, A. L., Mechanic, R. E., Shah, T. B., & Figueroa, J. F. (2021). Accountable Care Organ-
            izations during Covid-19: Routine care for older adults with multiple chronic condi-
            tions. Healthcare (Amsterdam, Netherlands), 9(1), 100511. https://doi.org/10.1016/
            j.hjdsi.2020.100511
            16. https://www.cms.gov/files/document/2021-shared-savings-program-fast-facts.pdf
            17. MedPac, A Data Book: Health care spending and the Medicare Program.
            18. https://www.cms.gov/files/document/2021-shared-savings-program-fast-facts.pdf
            19. Ibid and American Hospital Association data
            20. Definitive Healthcare, https://www.definitivehc.com/blog/how-many-fqhcs-are-
            there#:~:text=There%20are%20currently%201%2C368%20official%20FQHC%
            20locations%20in,a%20large%20volume%20of%20patients%2C%20particularly%20in%
            20California%3A




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