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For an ACO that reports all of the required measures in the APP Plus quality measure set, meeting the data completeness requirement at 414.1340 of this subchapter for all of the required measures in the APP Plus quality measure set, and administers the CAHPS for MIPS survey (except as specified in 414.1380(b)(1)(vii)(B) of this subchapter), CMS calculates the ACO's quality score as the sum of the ACO's MIPS Quality performance category score for all measures in the APP Plus quality measure set and the ACO's population and income adjustment bonus points calculated in accordance with paragraph (b)(4) of this section

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Environmental barriers can also include lack of time, limited access to healthy food, or poor social support