A decade of value-based care: How ACO models succeed

When the Centers for Medicare & Medicaid Services (CMS) introduced alternative payment models, it sought to transform health care by rewarding quality over quantity, a shift from the fee-for-service model. The vision was compelling: improve patient outcomes and reduce unnecessary costs.

Why value-based care matters more than ever

With U.S. health care spending reaching $4.9 trillion in 2023 — $14,570 per person — the urgency for value-based care has never been greater.¹ Meanwhile, the health care workforce faces an unprecedented burnout crisis.² When doctors spend only 27% of their office day on direct patient care,³ patients can experience fragmented care.

Combined with increasing pressure from health plans for better quality outcomes, this has many primary care organizations considering how to implement value-based care for their practice and patient population.

Accountable care organizations: A proven pathway to value-based care success

With multiple pathways into value-based care, practices can decide which model aligns best with their goals. Accountable care organizations (ACOs) are among the most common routes to success in value-based care. These groups of clinicians work together to improve care quality at lower costs through coordinated, prevention-focused care that addresses chronic illness and the root causes of disease. 

And they’ve been proven successful. 

Medicare Shared Savings Program (MSSP) ACOs continue to demonstrate the power of the ACO model, with Performance Year 2024 achieving the highest rates of shared savings since the program's inception.⁴

Among 476 participating ACOs serving 10.3 million assigned Medicare beneficiaries, 75% of ACOs earned performance payments totaling $4.1 billion while generating $2.4 billion in savings for Medicare — representing both the highest share of ACOs receiving performance payments and the highest savings amounts in the program's history.

Beyond financial performance, participating ACOs demonstrated substantial quality improvements. These results underscore how the ACO model's accountability structure drives both cost efficiency and improved patient outcomes.

Your value-based care journey: Getting started right

While transitioning to value-based care requires planning, the right ACO partner provides dedicated support, clear expectations and a manageable timeline.

Four main factors make the value-based care journey successful: 

• Partnership: Choosing an ACO partner who provides expertise and support 
• Data analytics: Accessing timely insights into patient risk and care gaps 
• Contracting: Providing practices and health plans with a competitive edge through value-based partnerships
• Investment: Enabling practices to manage population health effectively and meet performance metrics

The goal is meaningful work that produces visible results: healthier patients and financially sustainable practices.

The shift from fee-for-service to value-based care isn't just a payment model change; it's a fundamental reimagining of how primary care practices operate and thrive. Successful practices discover that better patient care and stronger financial performance are complementary outcomes, not competing goals.

Challenging "how we've always done things" can be difficult, but each milestone reinforces why this transformation is worth the effort. In today's evolving health care landscape, value-based care isn't just another opportunity; it's a path to long-term practice sustainability and clinical excellence.