The following table lists the top 50 ACOs in the U.S. according to Gross Generated Savings/Losses. This list also includes information on Patient Population and Earned Shared Savings Payment/Losses.

The Gross Savings/Losses amount is determined by calculating total benchmark expenditures minus total aligned beneficiary expenditures. This metric shows the total savings or losses (first to last dollar) dollar amount and represents total savings/loss generation to be split between the ACO and CMS.

The Earned Shared Savings Payments/Owe Losses figure indicates the ACO’s shares of savings or losses (positive value indicates amount to be paid by CMS to the ACO, negative value indicates amounts to paid by ACO to CMS). This amount accounts for several factors: the nature of the ACO’s risk arrangement (80% or 100% risk, plus the ACO’s elected savings/losses cap percentage, between 5-15%) and the reduction of shared savings payments by 2% due to sequestration.

The two ACOs with the highest gross savings on our list, Palm Beach Accountable Care Organization and AMITA Health Accountable Care Organization, lead the remainder of the top 50 by a significant margin. With a Gross Generated Savings of over $63 and $59 million, respectively, there is a decrease by nearly 31% from Palm Beach ACO to the third ACO, Scottsdale Health Partners. On average, the top 50 ACOs by Gross Savings had a patient population of nearly 33,000, a gross savings of  over $20.5 million, and an earned shared savings of $9.7 million.