Top 25 ACOs by gross savings

The Patient Protection and Affordable Care Act (ACA) created accountable care organizations (ACOs) to accomplish two goals: 1) deliver high-quality, coordinated care to specific patient bases and 2) reduce unnecessary expenses—while enabling ACOs to share in those savings via reimbursement through the Medicare Shared Savings Program.

An ACO’s gross savings/losses is a calculation of its total benchmark expenditures minus total aligned beneficiary expenditures. This metric shows the total amount saved or lost by the organization and represents the total savings (or losses) to be split between the ACO and the Centers for Medicare and Medicaid (CMS).

Check out our list of the top 25 ACOs in the U.S. according to their gross generated savings/losses.

Top ACOs with the highest generated savings in 2021

Rank ACO Name State Definitive ID Patient Population Earned Shared Savings Payments/Losses (Gross) Generated Savings/Losses
1 Baylor Quality Health Care Alliance LLC (FKA Baylor Scott & White Quality Alliance) TX 800687 129,866 $47,128,684 $96,365,360
2 Advocate Physician Partners Accountable Care IL 552160 113,033 $37,595,221 $77,622,055
3 Palm Beach Accountable Care Organization FL 552157 80,864 $54,320,998 $72,427,998
4 Steward National Care Network Inc MA 963485 161,364 $51,533,448 $68,711,265
5 Health Connect Partners WA 583280 115,202 $26,113,602 $67,395,249
6 Partners HealthCare Accountable Care Organization LLC MA 1002262 126,420 $46,711,743 $64,296,497
7 Mercy Health ACO MO 800734 134,096 $29,603,158 $60,919,682
8 Privia Quality Network LLC VA 583229 70,483 $42,266,717 $58,178,130
9 Millennium Accountable Care Organization FL 802274 66,651 $40,667,398 $55,435,857
10 Silver State ACO NV 583251 52,296 $32,725,201 $44,185,926
11 Caravan Health ACO 22 LLC MO 1002286 96,889 $15,432,521 $39,829,000
12 Piedmont Clinic GA 904025 70,348 $15,015,308 $38,686,785
13 Keystone ACO PA 574708 74,887 $18,489,695 $38,175,281
14 Mercy Health Select ACO OH 552206 67,576 $28,471,325 $38,140,550
15 Somos ACO NY 1002291 15,829 $18,313,628 $37,811,759
16 NewYork Quality Care NY 800766 34,239 $18,194,513 $37,565,826
17 Dignity Health Care Network LLC CA 1010027 70,308 $15,005,537 $37,513,843
18 NorthShore Physician Associates Value Based Care LLC IL 963492 49,021 $13,089,596 $33,296,270
19 Mayo Clinic Community ACO LLC MN 1002284 57,696 $12,651,109 $32,335,104
20 CHRISTUS Health Quality Care Alliance (AKA CPG Quality Care Alliance) TX 846874 63,512 $12,218,627 $31,534,424
21 Ochsner Accountable Care Network LA 574724 31,239 $22,355,580 $30,377,009
22 Memorial Hermann Accountable Care Organization TX 552219 43,213 $11,491,733 $29,560,729
23 Trinity Health Integrated Care MI 904056 72,956 $21,262,409 $29,266,697
24 WellMed Texas Medicare ACO LLC TX 1010058 27,330 $14,475,006 $28,950,011
25 New York Medical Partners ACO NY 904004 49,278 $11,041,383 $28,496,135

Fig 1. Data is from the Definitive Healthcare ConnectedCareView product. Data is sourced from Definitive Healthcare’s proprietary research and CMS Physicians Compare. Data accurate as of July 2022.

Which ACOs generated the greatest savings in 2021?

Definitive Healthcare data show that Baylor Quality Health Care Alliance LLC generated $96.3 million in Medicare savings in 2021, making them number one on our list. They’re also the third-largest ACO by patient population and earned shared savings payments (their take-home share of gross savings).

Advocate Physician Partners Accountable Care generated $77.6 million in gross Medicare savings in 2021, putting them in second with a 19% drop from the top position.

Taking third is the Palm Beach ACO, with $72.4 million in gross savings. They topped another list, however, with $54.3 million in earned shared savings payments.

The largest ACO by patient population, Steward National Care Network Inc, follows in fourth with $68.7 million in gross savings.

How are shared savings payments calculated?

Earned shared savings payments are the ACO’s share of savings to be paid by CMS. Losses can also be represented by this metric—though not seen in this data, negative values indicate an amount owed by the ACO to CMS.

Payments are determined based on several factors: the ACO’s risk arrangement (80% or 100% risk), the ACO’s elected savings/losses cap percentage (between 5-15%) and any reductions due to sequestration.

Learn more

Healthcare Insights are developed with healthcare commercial intelligence from the Definitive Healthcare platform. Want even more insights? Start a free trial today and get access to the latest healthcare commercial intelligence on hospitals, physician groups, ACOs and other providers.

Explore our data