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[526] In PY 2022, the most recent year for which data is available, savings achieved by ACOs relative to benchmarks amounted to $4.3 billion, of which ACOs received shared savings payments totaling $2.5 billion, and Medicare retained $1.8 billion in savings

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However, the authors did not conclude that e-cigarettes caused the decline and noted that it could have been influenced by other factors, such as anti-tobacco campaigns