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We propose to adjust an ACO's historical benchmark for use in reaching an initial determination of financial performance for a performance year, in cases where an ACO has a benchmark year that corresponds to a performance year for which we issued a revised initial determination

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Two systematic reviews of the literature (reviewing 54 studies that show the impact of plain tobacco packaging) have found that plain packaging as opposed to branded packs (1) reduces package appeal, (2) increases visibility and salience of health warnings, and (3) reduces confusion about the harm associated with use that has been shown to result from packs with corporate branding [28, 29]