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.

The number of ACOs by state


Fig 1. Heatmap shows the number of ACOs by state. Data is from Definitive Healthcare’s ConnectedCareView product. Data accessed in May 2023.

How many ACOs are there in the United States?

Definitive Healthcare tracks more than 1,600 active ACOs across the U.S.

The five states with the most ACOs are:

  1. California – 147
  2. Maryland – 113
  3. Texas – 111
  4. Florida – 107
  5. New York – 96

The volume of ACOs roughly correlates with state population. California, Texas, Florida, and New York are all among the five most populous states in the country, while Maryland ranks 19.

Among the states with the fewest ACOs, there is a four-way tie between New Mexico, North Dakota, Alabama, and the District of Columbia. Each state has one active ACO respectively, according to Definitive Healthcare data.

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.

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.

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