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ACOs with independent participants have struggled with their highest performing practices being recruited by multi-ACO enabler entities. From the other perspective, provider practices are challenged with selecting from an increasing array of enabler contracts as alternatives to CMS’s BASIC, ENHANCED and REACH models. When making PY 2023 track decisions, affected ACOs and practices benefit from analyzing the opportunities and threats introduced by this new reality. Threatened ACOs can proactively monitor the growth of enablers in their geographies and the migration of patients to other organizations. The full article breaks out the elements that go into addressing both of these situations in order to incorporate the growing presence of enablers into crucial 2023 participation decisions.