Healthcare Insights

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

RankACO NameStateDefinitive IDPatient PopulationEarned Shared Savings Payments/Losses(Gross) Generated Savings/LossesExplore Dataset
1Baylor Quality Health Care Alliance LLC (FKA Baylor Scott & White Quality Alliance)TX800687129,866$47,128,684 $96,365,360 Explore
2Advocate Physician Partners Accountable CareIL552160113,033$37,595,221 $77,622,055 Explore
3Palm Beach Accountable Care OrganizationFL55215780,864$54,320,998 $72,427,998 Explore
4Steward National Care Network IncMA963485161,364$51,533,448 $68,711,265 Explore
5Health Connect PartnersWA583280115,202$26,113,602 $67,395,249 Explore
6Partners HealthCare Accountable Care Organization LLCMA1002262126,420$46,711,743 $64,296,497 Explore
7Mercy Health ACOMO800734134,096$29,603,158 $60,919,682 Explore
8Privia Quality Network LLCVA58322970,483$42,266,717 $58,178,130 Explore
9Millennium Accountable Care OrganizationFL80227466,651$40,667,398 $55,435,857 Explore
10Silver State ACONV58325152,296$32,725,201 $44,185,926 Explore
11Caravan Health ACO 22 LLCMO100228696,889$15,432,521 $39,829,000 Explore
12Piedmont ClinicGA90402570,348$15,015,308 $38,686,785 Explore
13Keystone ACOPA57470874,887$18,489,695 $38,175,281 Explore
14Mercy Health Select ACOOH55220667,576$28,471,325 $38,140,550 Explore
15Somos ACONY100229115,829$18,313,628 $37,811,759 Explore
16NewYork Quality CareNY80076634,239$18,194,513 $37,565,826 Explore
17Dignity Health Care Network LLCCA101002770,308$15,005,537 $37,513,843 Explore
18NorthShore Physician Associates Value Based Care LLCIL96349249,021$13,089,596 $33,296,270 Explore
19Mayo Clinic Community ACO LLCMN100228457,696$12,651,109 $32,335,104 Explore
20CHRISTUS Health Quality Care Alliance (AKA CPG Quality Care Alliance)TX84687463,512$12,218,627 $31,534,424 Explore
21Ochsner Accountable Care NetworkLA57472431,239$22,355,580 $30,377,009 Explore
22Memorial Hermann Accountable Care OrganizationTX55221943,213$11,491,733 $29,560,729 Explore
23Trinity Health Integrated CareMI90405672,956$21,262,409 $29,266,697 Explore
24WellMed Texas Medicare ACO LLCTX101005827,330$14,475,006 $28,950,011 Explore
25New York Medical Partners ACONY90400449,278$11,041,383 $28,496,135 Explore

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.

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