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As described in our previous post, the MSSP saw for the first time a net savings for Medicare as calculated based on actual payments to ACOs (including bonuses) versus their benchmarks. The continuing trend of increasing net savings relative to benchmarks is consistent with a similar trend toward greater savings in “counterfactual” analyses that show larger reductions in net spending for MSSP beneficiaries compared to similar non-ACO beneficiaries. Many factors likely contributed to these trends toward greater savings, including more ACOs with more years of experience, as well as some poor performing ACOs dropping out of the program. Over time, as MSSP has become more established, more ACO enablers are working with larger numbers of ACOs with the goal of supporting effective care reforms and disseminating best practices.