Updated ACO and Value-Based Tracking Data is Now Available

David Muhlestein, William K. Bleser, Robert S. Saunders, and Mark B. McClellan publish Health Affairs Blog “All-Payer Spread of ACOs and Value-Based Payment Models in 2021: The Crossroads and Future of Value-Based Care”

Salt Lake City, June 17, 2021— Leavitt Partners and the Duke-Margolis Center for Health Policy released “All-Payer Spread of ACOs and Value-Based Payment Models In 2021: The Crossroads and Future of Value-Based Care”. This blog discusses how growth of Accountable Care Organizations (ACOs) plateaued just before and during the pandemic, and the movement toward value-based payment continues. Current growth of ACOs across all payers as well as other emerging population-focused value-based payment arrangements are shown. Future growth potential and recommendations for program improvements, supports, and opportunities to further the growth of value-based care are also highlighted.

Notable findings include:

  • ACO exits in the past two full years have outweighed entrants, a phenomenon not observed prior to 2019.
  • Medicare ACO contracts have plateaued, but commercial and Medicaid ACO contracts have continued to increase steadily.
  • Some rural hospital referral regions (HRRs) have high levels of ACO penetration, which is an exception to the rule, and penetration has also slightly increased in some geographic regions that historically had fewer ACOs.
  • Value-based payment activity may be moving to other models such as direct contracting and advanced primary care models.
  • Delivery organizations that managed best during the pandemic tended to be in some type of value-based payment arrangement.

While the growth of ACOs has plateaued just before and during the pandemic, the movement toward value-based payment models remains strong as health care organizations, employers, and especially patients want better, more convenient, and more affordable care that is difficult or impossible to sustain under fee-for-service payment. Making this happen will require significant efforts by the public and private sectors to move from the experimentation phase to a more systematic way of supporting care transformation—and venturing into new payment frontiers for value gains.

For a complete review of the findings, visit the Health Affairs Blog here.


About Leavitt Partners, an HMA Company:
Leavitt Partners, a leading consulting firm, is at the forefront of navigating change in healthcare by providing a holistic view of economic, market, delivery system, and political influences impacting healthcare. We improve lives by advancing value-based care, striving to make health more accessible, effective, and sustainable. For more information, visit