Healthcare Insights
The top ACOs ranked by total MSSP expenditures
An accountable care organization (ACO) is a network of doctors, hospitals, or other healthcare providers who voluntarily come together to provide coordinated care to a given patient population. This type of coordinated care delivery ensures that patients—especially those living with chronic conditions—receive the care they need when they need it. It also helps to prevent providers from unnecessarily duplicating services or making medical errors.
In October 2011, the Centers for Medicare and Medicaid Services (CMS) established ACOs under the Medicare Shared Savings Program (MSSP). Accountable care organizations who elect to participate in the MSSP agree to share both financial and medical responsibility for an assigned Medicare fee-for-service patient population.
Using data from the Definitive Healthcare ConnectedCareView product, the following table lists the ACOs with the highest total MSSP expenditures, according to the most recent 12-month interval tracked in our database. The most recent reporting year for MSSP ACO financial performance is 2021.
| Rank | ACO name | Definitive ID | State | Patient population | Total MSSP expenditures | Explore dataset |
|---|---|---|---|---|---|---|
| 1 | Steward National Care Network Inc | 963485 | MA | 148,277 | $1,750,411,782 | Explore |
| 2 | Partners HealthCare Accountable Care Organization LLC | 1002262 | MA | 126,357 | $1,589,692,018 | Explore |
| 3 | Baylor Quality Health Care Alliance LLC (FKA Baylor Scott & White Quality Alliance) | 800687 | TX | 125,258 | $1,269,568,295 | Explore |
| 4 | Mercy Health ACO | 800734 | MO | 126,889 | $1,253,592,769 | Explore |
| 5 | Health Connect Partners | 583280 | WA | 114,362 | $1,188,646,964 | Explore |
| 6 | Caravan Health ACO 22 LLC | 1002286 | MO | 106,323 | $1,156,107,225 | Explore |
| 7 | Advocate Physician Partners Accountable Care | 552160 | IL | 98,212 | $1,140,286,563 | Explore |
| 8 | Palm Beach Accountable Care Organization | 552157 | FL | 89,403 | $1,091,114,293 | Explore |
| 9 | Northwestern Medicine Physician Network ACO | 800691 | IL | 77,946 | $914,466,954 | Explore |
| 10 | Northwell Health ACO (FKA North Shore-LIJ MSSP ACO LLC) | 846919 | NY | 69,118 | $910,101,339 | Explore |
| 11 | Cleveland Clinic Medicare ACO | 800703 | OH | 78,051 | $853,893,781 | Explore |
| 12 | Caravan Health ACO 20 LLC | 1002285 | MO | 85,780 | $846,208,817 | Explore |
| 13 | The Accountable Care Organization | 583268 | VA | 80,287 | $842,134,923 | Explore |
| 14 | Delaware Valley ACO | 583199 | PA | 73,679 | $810,869,646 | Explore |
| 15 | Dignity Health Care Network LLC | 1010027 | CA | 68,071 | $810,457,095 | Explore |
| 16 | Aledade Accountable Care 22 (AKA Opportunity 2019 ACO) | 963580 | MD | 76,786 | $790,980,820 | Explore |
| 17 | Mayo Clinic Community ACO LLC | 1002284 | MN | 63,758 | $744,740,732 | Explore |
| 18 | Carolinas HealthCare System ACO LLC | 963623 | NC | 76,950 | $735,685,132 | Explore |
| 19 | Keystone ACO | 574708 | PA | 69,246 | $715,975,037 | Explore |
| 20 | Trinity Health Integrated Care | 904056 | MI | 65,619 | $709,425,477 | Explore |
| 21 | New York Medical Partners ACO | 904004 | NY | 46,794 | $667,175,136 | Explore |
| 22 | Mercy Health Select ACO | 552206 | OH | 60,671 | $658,156,003 | Explore |
| 23 | Banner Health Network ACO | 903939 | AZ | 68,075 | $657,712,840 | Explore |
| 24 | Piedmont Clinic ACO | 904025 | GA | 69,933 | $633,502,070 | Explore |
| 25 | CHRISTUS Health Quality Care Alliance (AKA CPG Quality Care Alliance) | 846874 | TX | 60,431 | $633,172,862 | Explore |
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 April 2023.
Which ACOs had the highest MSSP expenditures?
The accountable care organization with the highest MSSP expenditures as of 2021 is Steward National Care Network Inc, with $1,750,411,782. It serves an estimated patient population of 148,277 people.
Close behind in second place is Partners HealthCare Accountable Care Organization LLC. This ACO has a total MSSP expenditure of $1,589,692,018, as of 2021. It serves an estimated patient population of 126,357 people.
And in third place is Baylor Quality Health Care Alliance LLC with $1,269,568,295 in total MSSP expenditures. It serves an estimated patient population of 125,258 people.
The top ACOs on our list are spread across the U.S. Among the top 25, 11 ACOs are found along the East Coast, including the two facilities with the highest MSSP expenditures. Eleven are located in the Midwest, and the remaining are found along the West Coast.
For more healthcare insights on ACOs, check out our list on the top 25 ACOs ranked by patient population, and the top 25 ACOs by gross savings.
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