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So people at greatest risk for deficiency include those with low stomach acid (e.g., older adults and people on proton pump inhibitors or antacids) or low IF production (known as pernicious anemia), people on medications that interfere with B12 absorption (such as metformin), people who have had gastric surgery, those with GI conditions that impair nutrient absorption (like celiac or Crohn's disease), and people on vegan and vegetarian diets

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We do not agree that the use of a linear exchange function in HVBP would mean that more ASM participants would be familiar with a linear exchange function as we would not expect most ASM participants to be familiar with the HVBP payment methodology given that program focuses on hospitals and not individual clinicians or clinician groups