Top 25 ACOs by patient population

Considering that the United States spends 19.7% of its GDP on healthcare expenditures, the efficacy of healthcare delivery remains a key focus for provider organizations and payors.

Efforts continue to be made to tie outcomes to reimbursement and to shift from fee-for-service to value-based care, where more emphasis is placed on managing patient populations across the continuum of care.

What are accountable care organizations (ACOs)?

Accountable care organizations (ACOs) are formal groups of physicians, hospitals, or other care providers that voluntarily work together to deliver coordinated care to a defined population of patients.

ACOs aim to ensure that patients—especially those living with chronic conditions—receive the appropriate care they need when they need it, while preventing unnecessary duplication of services, medical errors, and expenses.

Check out our list of the top 25 ACOs in the U.S. according to their total patient population.

Top 25 ACOs by population

Rank Definitive ID ACO name ACO type Location Patient population
1 810909 TMA PracticeEdge (Texas Medical Association - Blue Cross and Blue Shield of Texas ACO) Commercial ACO Austin, TX 5,000,000
2 842940 Aetna - Childrens Hospital of Philadelphia (CHOP) ACO Commercial ACO Philadelphia, PA 1,400,000
3 552289 Aetna - Carilion Clinic ACO Commercial ACO Roanoke, VA 1,000,000
4 552388 Capital Bluecross - Heritage Medical Group ACO Commercial ACO Lemoyne, PA 700,000
5 579844 Anthem Blue Cross of California - Healthcare Partners ACO Commercial ACO El Segundo, CA 675,000
6 579912 Aetna - Riverside Health System ACO Commercial ACO Newport News, VA 500,000
7 585269 Horizon Blue Cross Blue Shield of New Jersey - Partners in Care ACO Commercial ACO East Brunswick, NJ 500,000
8 823406 Aetna - Virtual Medical Group ACO Commercial ACO Marlton, NJ 400,000
9 552285 Advocatecare ACO Commercial ACO Chicago, IL 375,000
10 969400 BCBS Illinois - Advocate Physician Partners Accountable Care Commercial ACO Rolling Meadows, IL 375,000
11 969315 BCBS Arizona - Banner Health Network ACO Commercial ACO Phoenix, AZ 350,000
12 553402 Cigna - Banner Health Network ACO Commercial ACO Phoenix, AZ 350,000
13 577487 UnitedHealthcare - Seton Health Alliance ACO Commercial ACO Austin, TX 320,000
14 969460 HealthPartners - Northwest Metro Alliance Commercial ACO Bloomington, MN 300,000
15 578002 Partners for Kids ACO Medicaid ACO Columbus, OH 300,000
16 585460 Blue Shield of California - EPIC ACO Commercial ACO Redlands, CA 273,000
17 835846 University Hospitals - Anthem Blue Cross and Blue Shield ACO Commercial ACO Cleveland, OH 270,000
18 947978 Cigna - DeKalb Physicians Health Organization Commercial ACO Decatur, GA 250,000
19 858080 DeKalb Medical Physicians Group - UnitedHealthcare ACO Commercial ACO Decatur, GA 250,000
20 849729 Humana - DeKalb PHO ACO Commercial ACO Decatur, GA 250,000
21 552351 Cigna - Westmed Medical Group ACO Commercial ACO Rye Brook, NY 237,000
22 553396 OptumCare - North American Medical Management California ACO Commercial ACO Ontario, CA 229,000
23 777076 Health Choice Utah Medicaid ACO South Jordan, UT 200,000
24 856423 Humana - John Muir Health ACO Commercial ACO Walnut Creek, CA 200,000
25 574791 Rainbow Care Connection Commercial ACO Cleveland, OH 200,000

Fig 1.  Data from the Definitive Healthcare ConnectedCareView product. ACO data is sourced from the Centers for Medicare & Medicaid Services and proprietary research. Data accurate as of August 2022.

Which ACO has the highest patient population?

TMA PracticeEdge, a commercial ACO based out of Austin, TX, has the highest patient population at 5 million. Aetna-Children’s Hospital of Philadelphia (CHOP) has a patient population of 1.4 million and Aetna – Carilion Clinic, a commercial ACO based out of Roanoke, VA, has a population of 1 million patients.

The top 25 ACOs by patient population on the list represent nearly 15 million patients with an average population of 596,160 patient each. Of the top 25, 18 are commercial ACOs and two are Medicaid ACOs.

What are the different types of ACOs?

ACOs cover patients who are covered by different types of healthcare payors. The main types of ACOs are:

  • Commercial ACOs: usually provider groups establishing an accountable care payment model with a non-government payer
  • Medicaid ACOs: aligns providers and payors incentives with a focus on value for a Medicaid population
  • Medicare Shared Savings Program: requires measurement and improvement in quality and an annual certification process

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