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Studies have examined how these metabolic changes affect various cellular processes including energy metabolism and gene expression

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However, as we explained in the CY 2026 PFS proposed rule, and restated elsewhere in this section of this final rule, this proposal to limit ACOs in this situation to the BASIC track protects ACOs from incurring a larger shared losses rate of up to 75 percent (see § 425.610(f)(4)), and this proposal protects the Medicare Trust Funds from paying a larger shared savings rate of up to 75 percent (see § 425.610(d)(4)), which could result under the ENHANCED track