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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.

List of ACOs by state

Rank State Number of ACOs Explore dataset
CA 249 Explore
MD 132 Explore
MA 128 Explore
TX 119 Explore
FL 108 Explore
NY 107 Explore
TN 89 Explore
CO 75 Explore
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 Explore
35 NV Explore
36 VT Explore
37 RI Explore
38 DE Explore
39 OK Explore
40 MS Explore
41 MT Explore
42 AL Explore
43 HI Explore
44 AR Explore
45 SD Explore
46 WV Explore
47 ND Explore
48 DC Explore
49 NM Explore
50 AK 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.

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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.