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One worry about accountable care organizations (ACOs) is that their growth would lead to the consolidation of physician practices. A new study finds that concern has proven real. Researchers examined changes in physician practice sizes associated with ACO market penetration three years after the launch of the Medicare Shared Savings Program, which began in 2012 and is one of the country’s largest ACO programs. In counties with more ACOs, they found more large practices and fewer small practices, according to a study published in Health Affairs.