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Experts say the final rules for accountable care organizations (ACOs) under the Medicare Shared Savings Program (MSSP) are much better than the draft rules issued last spring. And they expect physicians and other health care professionals to be more willing to participate in Medicare ACOs as a result. But Texas Medical Association officials say there are still some flaws in the design of the MSSP even though te Centers for Medicare & Medicaid Services incorporated several of TMA's suggested changes to the rules.