; and (2) in item (bb)— (A) by striking 75 percent and inserting the applicable percent ; and (B) by striking 50 percent and inserting 10 percentage points less than the applicable percent . 4 Study on alternative payment models and medicare+choice Not later than 18 months after the date of enactment of this Act, the Comptroller General of the Government Accountability Office shall study and submit to the appropriate committees of Congress a report evaluating the benefits and flexibilities provided to support alternative payment models (as defined under section 414.1305 of title 42, Code of Federal Regulations (or a successor regulation)) and Medicare+Choice Organizations (as defined in section 1859(a)(1) of the Social Security Act ( 42 U.S.C. 1395w–28(a)(1) ). The objective of such report shall be to better understand the effect of these programs’ different policies on different types of participating patients and providers, including specialty, safety net, small practice, and rural providers, with the goal of identifying areas to enhance alignment between such programs’ policies and benchmarks including through mechanisms that could facilitate greater alignment in policies and benchmarks and to encourage the adoption of value-based arrangements across payers or that could otherwise increase parity in the flexibilities available to alternative payment models and Medicare+Choice Organizations.