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Preliminary evaluation results of the first 2 performance years of the Global and Professional Direct Contracting Model, before its transition to the ACO REACH Model, suggest that participating ACOs had mixed results in gross spending but consistent, significant increases in net spending relative to a comparison group of similar FFS Medicare beneficiaries in their markets, which included beneficiaries assigned to ACOs participating in the Shared Savings Program

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routine B12 level monitoring is generally unnecessary once replacement is established, as levels do not reliably correlate with tissue stores Important safety considerations: Older adults may have impaired renal function, though this rarely affects B12 therapy given its wide safety margin