One of the major benefits to a provider beginning or joining an accountable care organization (ACO) is the potential for achieving shared savings from the Medicare Shared Savings Program. This essay provides a strategic plan for ACO participants to maximize their shared savings through a physician-led structure and the creation of a high-value referral network. Physician-led ACOs are generally more flexible than those affiliated with a hospital and can implement more effective cost-saving initiatives, focus more intently on lowering the cost of delivering primary care, and achieve higher shared saving rates. Combining the strategies presented in this essay allows ACOs, no matter their size, to maximize their shared savings and become a model for future ACOs.