(Bloomberg) -- Health systems in at least 14 states are joininga new version of a program under Obamacare meant to lowercosts in the half-trillion-dollar Medicare program, after somegroups quit an earlier effort.

It’s the latest initiative to change the way hospitals anddoctors are paid under the Patient Protection and AffordableCare Act, which became law in 2010 as President Barack Obama’ssignature domestic policy achievement.

In all, 21 systems are taking part in the Next GenerationAccountable Care Organization program, which started on Jan. 1, theCenters for Medicare and Medicaid Services said Monday. Thesystems, such as Steward Health Care and WakeMed, will cover about650,000 individuals this year.

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