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One major criticism of ACOs, MIPS, and other new payment models is that these systems create perverse incentives for organizations to select lower risk physicians or for physicians to select lower risk patients. As a result, some have concerns that shifting away from fee-for-service without adequate risk-adjustment methods could exacerbate disparities in care among minority and medically complex patient populations commonly seen as higher risk. How can we address these issues when moving from volume-based to value-based payment?