The document discusses the rise of Accountable Care Organizations (ACOs) and their impact on healthcare providers and commercial teams. It provides definitions for the different types of ACOs, including those focused on Medicare, Medicaid, commercial payers, and pioneers that take on more risk. The summary lists the top 30 ACOs ranked by number of physician affiliations, with the largest having over 7,000 participating physicians. Commercial teams will need to adapt their strategies to target decision makers within ACOs rather than individual providers, as ACOs consolidate influence over treatment and purchasing decisions.

1. MARKET
INSIGHTS
Top 30 Accountable Care Organizations
Market Insights Report
FEBRUARY 2017

2. SK&A 2601 Main Street, Suite 650 Irvine CA 92614 800-752-5478 www.skainfo.com
©2017 SK&A. All rights reserved. Trademarks are registered in the United States and in various other countries.
The Shift in Provider Influence
In today’s changing healthcare environment, provider organizations face intensifying pressure to reduce costs and
improve quality of care. To make progress on these divergent goals, healthcare provider organizations, including
hospitals and health systems, are developing new ways of integrating with physicians and other clinicians for deliv-
ering care to patients. In light of this, many provider organizations are currently exploring the benefits of transition-
ing to an accountable care enterprise.
An Accountable Care Organization (ACO) is the equivalent of a joint venture between physicians, medical groups,
clinics, health systems, hospitals and, in many cases, insurance companies. They have come together voluntarily
to give coordinated, high quality care to their patients, with the goal of creating efficiencies, reducing costs,
decreasing errors, and improving safety. In this report, SK&A shares insights on how the rise of ACOs impact
commercial teams’ interaction with providers and presents a list of the top 30 accountable care organizations
today.
Healthcare’s Brave New World
Under ACOs, decision making is more centralized and controlled. ACOs have significant control over decisions
related to formulary, treatments, health IT adoption, sales-rep access, drug sampling policies, new product uptake
and more. With so much at stake, service providers must understand how to position themselves in the eyes of the
ACOs. Do you know who your new influencers are?
ACOs are focused on coordinated and collaborative delivery of care to meet patient-centric objectives, rather than
service volume. Each organization needs to define a unique operating model and structure to support their chosen
accountable care strategy. SK&A has identified four ACO categories:
• MedicareSharedSavingsProgramsaredesignatedtocoordinatecareforMedicarefee-for-servicebeneficiaries.
• Commercial ACOs are distinct from Medicare ACOs in that a commercial payer, rather than Medicare is the
entity providing the financial incentives for quality and cost performance to provider organizations.
• Medicaid ACO is a fee for service through Medicaid. In fee-for-service Medicaid, reimbursement rates are set by
the state, leaving no room for providers to raise prices. Also known as Accountable Care Collaborative.
• Pioneer ACO is designed for early adopters of coordinated care that take on more risk than the MSS model.
Regardless of the ACO model the provider organization chooses, the operating model and structure should be
designed to foster collaboration, teamwork, and trust. It will include a shift of roles, responsibilities, standardization,
and decision making.
What does this mean for your commercial success? Primarily, it will mean changes in tactics, audience, and territory
alignment. Traditionally, suppliers have successfully engaged and influenced providers site by site. As ACOs expand,
individual providers have significantly less decision making power and influence. Commercial teams need to seek out
and engage the right decision makers in the new ecosystem.
To formulate successful engagement strategies, commercial teams operating in multiple regions need to identify
territories that are dominated by ACOs versus healthcare markets that comprise mainly independently owned entities.
Top 30 Accountable Care Organizations
Through extensive telephone interviews and custom research from its research centers, SK&A has identified 703
ACOs including profiles for directors, administrators, committee voting members and other personnel. The number
of physicians, nurse practitioners and physician assistants participating in ACOs exceeds 304,000. As of this writing,
there are nearly 479,000 total healthcare providers and business personnel aligned with ACOs. These are the top 30
ACOs ranked in terms of total number of physician affiliations.
For more information about Top 30 Accountable Care Organizations, please contact:
Jack Schember, Director of Marketing email: jack.schember@quintilesims.com phone: 949-476-2051

3. SK&A 2601 Main Street, Suite 650 Irvine CA 92614 800-752-5478 www.skainfo.com
©2017 SK&A. All rights reserved. Trademarks are registered in the United States and in various other countries.
Top 30 Accountable Care Organizations
For more information about Top 30 Accountable Care Organizations, please contact:
Jack Schember, Director of Marketing email: jack.schember@quintilesims.com phone: 949-476-2051
Ranked by Total Participating Physicians within the ACO***
Rank Corporation Headquarters State
Total
Facilities*
Total
Participating
Physicians
Type of
ACO**
1 HealthCare First South Los Angeles Los Angeles CA 2,668 7,237 Medicaid
2 Heritage Provider Network & Anthem Blue Cross of CA Northridge CA 4,177 7,207 Commercial
3 Heritage California ACO Northridge CA 3,905 6,876 MSS Program
4 Tenet Healthcare & Humana Dallas TX 1,963 6,644 Commercial
5 Hill Physicians/Dignity Health/University of CA San Francisco &
Health Net
San Ramon CA 2,118 5,883 Commercial
6 Hill Physicians & Anthem Blue Cross San Ramon CA 2,089 5,793 Commercial
7 Advantage Health Network Dallas TX 1,826 4,519 Commercial
8 Physician Organization of Michigan ACO LLC Ann Arbor MI 1,077 4,179 MSS Program
9 Hill Physicians Dignity Health Calpers & Blue Shield of CA San Ramon CA 1,602 4,044 Commercial
10 Health Share of Oregon Portland OR 1,258 3,912 Medicaid
11 Partners Healthcare Boston MA 739 3,306 Pioneer
12 Baylor Scott & White Quality Alliance & Aetna Whole Health Dallas TX 772 2,959 Commercial
13 Baylor Scott & White Quality Alliance Dallas TX 765 2,949 MSS Program
14 Baylor Scott & White Quality Alliance & UnitedHealthCare Dallas TX 766 2,949 Commercial
15 Cleveland Clinic Cigna ACO Cleveland OH 424 2,912 Commercial
16 Fairview & North Memorial Vantage w/ Medica Minneapolis MN 738 2,865 Commercial
17 Cleveland Clinic Medicare ACO LLC Independence OH 414 2,833 Commercial
18 NewYork Quality Care ACO New York NY 629 2,754 Commercial
19 Health Connect Partners Seattle WA 684 2,740 MSS Program
20 FamilyCare Health Portland OR 1,045 2,728 Medicaid
21 HealthCare Partners ACO LLC & Cigna El Segundo CA 870 2,683 Commercial
22 HealthCare Partners ACO LLC & Anthem Blue Cross Blue Shield El Segundo CA 869 2,678 Commercial
23 Indiana University Health ACO Inc Indianapolis IN 596 2,645 MSS Program
24 HCP ACO California LLC El Segundo CA 837 2,618 MSS Program
25 North American Medical Management & Aetna Ontario CA 1,133 2,606 Commercial
26 Henry Ford Physicians Accountable Care Organization Detroit MI 473 2,488 Commercial
27 Health & Humana Columbus OH 748 2,476 Commercial
28 Steward Promise ACO Dedham MA 1,266 2,393 MSS Program
29 Hill Physicians/Dignity Health/University of CA San Francisco &
Blue Shield CA
San Ramon CA 708 2,291 Commercial
30 Optum Accountable Care Phoenix AZ 661 2,257 Commercial
* Total Facilities: Total Affiliated Facilities are locations where one or more contacts are affiliated to the specific ACO
** MSSP = Medicare Shared Savings Program ACO
Physicians and Facilities may be affiliated to more than one ACO. These multiplicities are reflected in the counts above.
Source: SK&A, February 2017