Top 10 Medicare shared savings program ACOs

Which ACO ranks highest for shared savings earned?

Florida-based Palm Beach Accountable Care Organization leads with over $61.9 million in earned shared savings, followed closely by the Baylor Quality Health Care Alliance in Texas at about $61 million and Privia Quality Network LLC in Virginia with about $41.6 million. All three organizations operate under the Enhanced MSSP track, which has higher risk and reward potential.

What is an ACO?

Founded in 2011 by the Centers for Medicare and Medicaid Services (CMS), ACOs, or accountable care organizations, are groups of healthcare providers that work together to care for certain patient populations. ACOs deliver coordinated care that helps healthcare providers—like hospitals and physicians—improve patient satisfaction, improve population health, and reduce per capita healthcare costs.

What is the Medicare Shared Savings Program?

The Medicare Shared Savings Program (MSSP) is a key initiative to promote accountability and care coordination among providers for Medicare beneficiaries. The MSSP encourages healthcare providers, through Accountable Care Organizations (ACOs), to work together to improve the quality of care while reducing costs for Medicare patients. Below are key features:

• Accountable care organizations (ACOs): Groups of doctors, hospitals, and other healthcare providers who come together to provide coordinated care to a specific patient population.
• Shared savings: ACOs that reduce healthcare spending while meeting quality benchmarks can share in the savings they generate for Medicare. This provides a financial incentive to deliver efficient, high-quality care.
• Quality metrics: ACOs are evaluated based on their ability to meet various quality measures, such as patient satisfaction, preventive care, and management of chronic conditions.
• Risk levels: ACOs can participate under different risk-sharing models, ranging from basic models with limited financial risk to enhanced models that allow for more significant potential savings and risks.

When did the Medicare Shared Savings Program start?

The Medicare Shared Savings Program (MSSP) was established by the Affordable Care Act (ACA) and officially began on April 1, 2012. Initially, the program included two tracks: Track 1 and Track 2. Over time, the MSSP has evolved to include additional tracks. In 2016, Track 3 was introduced, followed by Track 1+ in 2018. 

Today, the program offers Basic and Enhanced tracks, which provide varying levels of risk and care management strategies. The Basic track is designed for ACOs willing to assume lower risk, while the Enhanced track offers the potential for greater savings but requires ACOs to take on more financial risk. 

Additionally, eligible ACOs participating in the Basic track can take advantage of a glide path, starting under a one-sided model and progressing through incremental levels of increasing risk and potential reward. This evolution allows ACOs to choose a participation model that best fits their capabilities in managing care for assigned Medicare fee-for-service beneficiaries.

Medicare Shared Savings Program results

As supported in our table above, many ACOs that participate in the MSSP are successful in saving earnings. The top 10 ACOs on our list collectively earned approximately $203.4 million in shared savings, demonstrating significant success in managing costs and improving care quality for their patient populations.

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