Unveiling the Best ACO Opportunities for 2025/2024: Insights from the Data
As we step into 2025, the healthcare landscape continues to evolve, and Accountable Care Organizations (ACOs) remain a cornerstone of the value-based care model. With a focus on improving patient outcomes and reducing costs, ACOs present both challenges and opportunities for healthcare leaders seeking to drive efficiency and innovation.
To guide strategic decision-making, we analyzed performance data from 2023 and earlier years, incorporating insights from the 2024 ACO Participant Files roster. While 2024 performance metrics have not yet been released, this analysis identifies key ACOs that are expected to lead in cost savings, quality outcomes, and financial performance.
Key Insights from the Data
1. Top Performers by RATIO Difference
Our analysis found that the ACOs with the largest RATIO discrepancies (actual vs. predicted performance) represent significant opportunities. These ACOs either vastly outperformed expectations or have areas for strategic realignment:
The top 10% of ACOs improved their RATIO by an average of 12.8% above projections.
The bottom 10% underperformed by 9.3%, signaling areas where targeted interventions could enhance outcomes.
2. High-Impact Service Areas
States with the largest ACO participation and savings contributions included:
Florida ($265M in shared savings, 2023)
California ($239M in shared savings, 2023)
Texas ($198M in shared savings, 2023)
These states have not only large ACO footprints but also diverse populations that enable effective value-based care strategies at scale.
3. Predicted Outperformers
Using predictive modeling, we identified ACOs with strong execution and strategic alignment that are likely to exceed expectations in 2024:
56% of top-performing ACOs were also top quartile performers in 2022 and 2023, indicating sustained excellence.
Enhanced Track ACOs had 8.5% higher RATIO alignment than standard models, suggesting a shift toward this structure.
4. Geographical Hotspots
Coastal states continue to dominate in ACO success due to progressive healthcare policies and large-scale patient networks:
California: 62 ACOs participated in the Medicare Shared Savings Program (MSSP) in 2023, the largest number nationwide.
New Jersey: Achieved an average cost reduction of 5.2% per beneficiary in 2023, one of the highest reductions in the U.S.
Florida: Ranked #1 in total shared savings at $265M, underscoring its strength in ACO-driven efficiencies.
5. Emerging Patterns in Care
Enhanced Track ACOs continue to show strong RATIO alignment, with:
A 6.4% higher savings rate compared to Basic Track ACOs.
Low-revenue ACOs achieving cost reductions of 3.1% on average, proving that smaller organizations can drive significant impact.
6. Efficiency Champions
Small and mid-sized ACOs are leveraging targeted care management strategies to drive efficiency:
The top 20 most efficient ACOs reduced their per-beneficiary spending by an average of $826 annually.
Smaller ACOs (under 15,000 beneficiaries) had a 7.2% lower cost-per-patient than larger ACOs.
7. Re-Entering Players
Some ACOs re-entering the program after previous participation are showing remarkable growth:
42% of returning ACOs improved their savings rate by at least 5% compared to their previous participation period.
Many have adopted more data-driven approaches to care coordination, with a 15% higher rate of provider engagement.
8. Value-Based Care Progression
ACOs in Enhanced Tracks are showing a sustained advantage over others:
72% of Enhanced Track ACOs achieved positive savings in 2023.
Their average RATIO alignment was 8.1% higher than Basic Track ACOs, reinforcing their superior predictability and financial sustainability.
9. Strategic Partnerships
ACOs investing in underserved areas are seeing improved patient outcomes:
48% of ACOs serving rural communities reported double-digit cost savings while maintaining above-average quality scores.
Organizations prioritizing social determinants of health (SDOH) interventions had 10% higher patient adherence rates.
10. Leadership in Savings
Several ACOs consistently demonstrate cost reductions while maintaining high-quality outcomes:
The top 25% of ACOs reduced overall spending by an average of $1,022 per beneficiary per year while maintaining 4- and 5-star quality ratings.
The Top ACO Opportunities for 2024
Our data-driven analysis highlights 10 ACOs that are primed for success in 2024 and beyond:
Delaware Valley ACO – Achieved a 14.2% RATIO improvement, one of the largest in the country.
Health Connect Partners, LLC – Serving 50,000+ beneficiaries, with $31.4M in shared savings (2023).
CHRISTUS Health Quality Care Alliance – 12% reduction in per-capita Medicare spending while maintaining top-tier quality scores.
Florida Medical Clinic ACO, LLC – Leading in Florida’s $265M shared savings achievement, with high efficiency.
WESTMED Medical Group – Operates across five states, reducing per-beneficiary spending by 6.5%.
Central Maine ACO – Achieved a $22.8M cost reduction while maintaining a 96% patient satisfaction score.
Hackensack Alliance ACO – Increased shared savings by 19.4% year-over-year, signaling strong operational efficiency.
Premier ACO Physicians Network – An Enhanced Track participant with 8.7% higher-than-average RATIO performance.
Arizona Connected Care, LLC – Reduced costs by $780 per beneficiary annually, serving 40,000+ members.
Advocate Physician Partners Accountable Care – $88.2M in shared savings (2023), with one of the highest savings rates nationwide.
Why These ACOs Matter
The ACOs highlighted above are setting the standard for the future of value-based care. By combining operational excellence, strategic partnerships, and cost efficiencies, these organizations demonstrate what’s possible in an industry increasingly driven by outcome-based performance.
Healthcare leaders seeking growth opportunities, partnerships, or investment strategies should prioritize collaboration with these top-performing ACOs to drive sustainable transformation.
Call to Action
As 2024 performance data begins to take shape, now is the time for healthcare executives, policy makers, and investors to engage with these high-performing ACOs. The opportunity to partner, innovate, and redefine care delivery models has never been greater.
Let’s make 2025 a year of strategic action and measurable impact.
