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.

Top 25 ACOs with the highest total MSSP expenditures as of 2021

RankACO nameDefinitive IDStatePatient populationTotal MSSP expendituresExplore dataset
1Steward National Care Network Inc963485MA148,277$1,750,411,782 Explore
2Partners HealthCare Accountable Care Organization LLC1002262MA126,357$1,589,692,018 Explore
3Baylor Quality Health Care Alliance LLC (FKA Baylor Scott & White Quality Alliance)800687TX125,258$1,269,568,295 Explore
4Mercy Health ACO800734MO126,889$1,253,592,769 Explore
5Health Connect Partners583280WA114,362$1,188,646,964 Explore
6Caravan Health ACO 22 LLC1002286MO106,323$1,156,107,225 Explore
7Advocate Physician Partners Accountable Care552160IL98,212$1,140,286,563 Explore
8Palm Beach Accountable Care Organization552157FL89,403$1,091,114,293 Explore
9Northwestern Medicine Physician Network ACO800691IL77,946$914,466,954 Explore
10Northwell Health ACO (FKA North Shore-LIJ MSSP ACO LLC)846919NY69,118$910,101,339 Explore
11Cleveland Clinic Medicare ACO800703OH78,051$853,893,781 Explore
12Caravan Health ACO 20 LLC1002285MO85,780$846,208,817 Explore
13The Accountable Care Organization583268VA80,287$842,134,923 Explore
14Delaware Valley ACO583199PA73,679$810,869,646 Explore
15Dignity Health Care Network LLC1010027CA68,071$810,457,095 Explore
16Aledade Accountable Care 22 (AKA Opportunity 2019 ACO)963580MD76,786$790,980,820 Explore
17Mayo Clinic Community ACO LLC1002284MN63,758$744,740,732 Explore
18Carolinas HealthCare System ACO LLC963623NC76,950$735,685,132 Explore
19Keystone ACO574708PA69,246$715,975,037 Explore
20Trinity Health Integrated Care904056MI65,619$709,425,477 Explore
21New York Medical Partners ACO904004NY46,794$667,175,136 Explore
22Mercy Health Select ACO552206OH60,671$658,156,003 Explore
23Banner Health Network ACO903939AZ68,075$657,712,840 Explore
24Piedmont Clinic ACO904025GA69,933$633,502,070 Explore
25CHRISTUS Health Quality Care Alliance (AKA CPG Quality Care Alliance)846874TX60,431$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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