Healthcare Insights
How many accountable care organizations (ACOs) are in each state?
An accountable care organization (ACO) is a healthcare delivery model that aims to improve the quality and coordination of care for patients while reducing costs. It is a network of healthcare providers, including doctors, hospitals, and other healthcare professionals, who voluntarily come together to provide coordinated care to a specific population of patients.
The primary goal of an ACO is to promote collaboration and integration among different healthcare providers to deliver more effective and efficient care. By working together, ACO members strive to improve patient outcomes, enhance patient satisfaction, and achieve cost savings by avoiding unnecessary duplication of services or hospital admissions.
Using data from our ConnectedCareView product, the heatmap below shows how many ACOs are in each state across the U.S. to date. It’s important to note that not all states report how many ACOs they have and may use different terminology when referring to their ACO initiatives.
How many ACOs are there in the U.S.?
Definitive Healthcare tracks more than 1,800 active ACOs across the U.S. Our list of accountable care organizations by state highlights the states with the most and fewest ACOs.
| Rank | State | Number of ACOs | Explore dataset |
|---|---|---|---|
| 1 | CA | 249 | Explore |
| 2 | MD | 132 | Explore |
| 3 | MA | 128 | Explore |
| 4 | TX | 119 | Explore |
| 5 | FL | 108 | Explore |
| 6 | NY | 107 | Explore |
| 7 | TN | 89 | Explore |
| 8 | CO | 75 | Explore |
| 9 | AZ | 64 | Explore |
| 10 | NJ | 63 | Explore |
| 11 | WA | 59 | Explore |
| 12 | IL | 59 | Explore |
| 13 | OH | 56 | Explore |
| 14 | PA | 55 | Explore |
| 15 | CT | 48 | Explore |
| 16 | VA | 48 | Explore |
| 17 | MI | 47 | Explore |
| 18 | NC | 43 | Explore |
| 19 | OR | 37 | Explore |
| 20 | MN | 34 | Explore |
| 21 | ME | 29 | Explore |
| 22 | MO | 26 | Explore |
| 23 | GA | 24 | Explore |
| 24 | IN | 21 | Explore |
| 25 | IA | 20 | Explore |
| 26 | WI | 16 | Explore |
| 27 | NE | 15 | Explore |
| 28 | SC | 13 | Explore |
| 29 | ID | 13 | Explore |
| 30 | NH | 12 | Explore |
| 31 | UT | 11 | Explore |
| 32 | KY | 10 | Explore |
| 33 | LA | 10 | Explore |
| 34 | KS | 9 | Explore |
| 35 | NV | 9 | Explore |
| 36 | VT | 8 | Explore |
| 37 | RI | 8 | Explore |
| 38 | DE | 8 | Explore |
| 39 | OK | 6 | Explore |
| 40 | MS | 4 | Explore |
| 41 | MT | 4 | Explore |
| 42 | AL | 3 | Explore |
| 43 | HI | 3 | Explore |
| 44 | AR | 3 | Explore |
| 45 | SD | 2 | Explore |
| 46 | WV | 2 | Explore |
| 47 | ND | 1 | Explore |
| 48 | DC | 1 | Explore |
| 49 | NM | 1 | Explore |
| 50 | AK | 1 | Explore |
Fig. 1. Data is from Definitive Healthcare’s ConnectedCareView product. Data October May 2025.
Which state has the most ACOs?
From the list, we can see that California has the highest number of ACOs with 249, followed by Maryland and Massachusetts with 132 and 128 ACOs respectively. Rounding out the top five is Texas with 119 ACOs and Florida with 108. The numbers gradually decrease across other states, with North Dakota, New Mexico, Alaska, and Washington D.C. having the lowest count with only one ACO each. According to our database, the state of Wyoming has zero accountable care organizations.
In general, as the population of a state increases, the number of ACOs also tends to increase, but the relationship is not extremely strong. While states with larger populations might be expected to have more ACOs due to greater healthcare demand, other factors such as state regulations, healthcare delivery models, and provider participation rates can also influence ACO formation.
For a deeper understanding of ACOs, consider checking out the top 25 ACOs ranked by gross savings and the top 25 ACOs ranked by patient population.
The number of ACOs by state
Fig 2. Heatmap shows the number of ACOs by state. Data is from the Definitive Healthcare’s ConnectedCareView product. Data accessed October 2025.
How to use ACO data to fuel your healthcare sales and marketing strategy
Sales and marketing professionals can leverage ACO data to sharpen their strategies by focusing on the organizations and decision-makers most responsible for value-based care initiatives. Because ACOs are judged on lowering costs and improving patient outcomes, data on their structure, size, and performance helps identify high-value accounts and the leaders who influence purchasing decisions.
With insight into where an ACO struggles—whether with chronic disease management, readmission rates, or preventive screenings—sales teams can tailor conversations to highlight how their solutions directly address these gaps and support quality benchmarks.
Marketing teams can also personalize campaigns by geography, condition, or performance metrics, ensuring outreach resonates with the ACO’s goals. By tying products and services to shared savings opportunities and measurable improvements in outcomes, organizations can not only target the right prospects but also build credibility and demonstrate ROI in terms that matter most to ACOs, ultimately strengthening engagement and driving adoption.
Are ACOs only for Medicare?
No. While ACOs were originally established as a payment model for Medicare, many private sector health plans have launched their own ACO networks. These ACOs are usually offered as distinct insurance product options available to individuals and employers. Often, they are offered through a health maintenance organization or a preferred provider organization.
Learn more
Healthcare Insights are developed with data from the Definitive Healthcare platform. Want even more insights? Start a free trial today and get access to the latest intelligence on hospitals, physician groups, ACOs, and other providers.