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While the PMC agrees that this performance measure provides a meaningful clinical impact, there is concern with the feasibility of the performance measure at individual physician level. The performance measure has not been tested at the levels of individual physician and group practice; therefore, more data are needed to apply it to any physician, regardless of the specialty. It would be appropriate to apply this performance measure at health plan level. The PMC recommends adjusting the starting age for denominator inclusion to 65, based on the ACP clinical guideline. The definitions for frailty should be refined for ease of implementation.