The document presents the top 25 integrated delivery networks (IDNs) in the U.S. ranked by the number of accountable care organization (ACO) affiliations, with CommonSpirit Health leading at 57 affiliations. It highlights the ACO model, which aims to provide coordinated care and reduce costs primarily for Medicare beneficiaries. The average revenue of the top 25 IDNs is noted, emphasizing that CommonSpirit Healthcare accounts for one-third of the net patient revenue among this group.

1. Top 25 IDNs by
ACO Affiliations
Definitive Healthcare defines an Accountable Care organization (ACO) as a group of doctors,
hospitals, or other healthcare providers, who voluntarily come together to provide coordinated
care to a patient population.
The goal of the ACO model is to reduce total care costs for a specific patient population. Each ACO
has a defined patient population for which it is held accountable in terms of care cost and quality.
Patient populations are primarily comprised of Medicare beneficiaries. Definitive Healthcare tracks
the following types of ACOs: CMS ACO Models , Medicaid ACOs, and Commercial ACOs.
The following table lists the top 25 IDNs in the U.S. according to number of Accountable Care
Organization (ACO) affiliations.
The IDN with the highest number of ACO affiliations on our list, CommonSpirit Healthcare, leads by
a significant margin, with 57 affiliations compared to our second IDN on the list, Trinity Healthcare
with 29 ACOs.
Fewer than 10 of the top 25 IDNs reported more than 15 ACO affiliations, with three of those with
25 or more.
On average, the top 25 IDNs by number of ACO affiliations has 49 hospitals in-network and brought
in more than $9.4 billion in net patient revenue during the most recent reporting period. This is
about one-third of the net patient revenue earned by CommonSpirit Healthcare, the IDN with the
highest number of affiliations.
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2. Top 25 IDNs by ACO Affiliations
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1. CommonSpirit Health 981465 $28,543,327,983 203 57
2. Trinity Health 4712 $13,117,384,362 57 29
3. University of California (UC) Health 560423 $12,063,083,551 20 25
4. Ascension Health 4695 $17,858,985,891 128 24
5. OptumCare 992401 $228,265,767 5 22
6. Dignity Health 4698 $11,817,607,947 48 19
7.
University of California San
Francisco Health System
551802
$4,223,673,020 7 18
8. Tenet Healthcare 4685 $13,652,040,731 83 18
9.
Massachusetts Bureau of Public Health
Facilities
7097
$6,021,103 * 10 17
10. Community Health Systems 542233 $10,516,859,767 106 16
11. Providence St Joseph Health 4716 $15,696,161,401 56 16
12. Banner Health 4732 $5,978,246,087 31 12
13. Advocate Aurora Health 965729 $7,919,307,404 30 11
14. Bon Secours Mercy Health 975303 $7,665,638,269 39 11
15. HCA Healthcare 4710 $42,213,477,560 211 11
16. Atlantic Health System 4904 $2,358,129,142 6 10
17. University Hospitals Health System 4729 $5,372,012,087 18 9
18. UnityPoint Health 4711 $3,719,397,585 35 9
19. Yale New Haven Health System 4767 $4,116,717,446 10 8
20.
Providence Health & Services - Oregon
and Southwest Washington
846987
$2,476,431,667 8 8
21. LifePoint Health 7004 $8,059,322,200 86 8
22. AMITA Health 837734 $3,525,344,790 18 8
23.
Providence Health & Services -
California
846985
$2,214,932,915 6 8
24. Trinity Health of New England 7234 $1,566,581,794 6 8
25. Wellforce 780812 $1,914,679,481 8 8
Net Patient
Revenue # of Hospitals
# of ACO
Affiliations
* Net Medicare Revenue
Fig 1 Data from Definitive Healthcare based on MSSP - Published member list, other member lists, and proprietary research as reported by
the most recent data available.
IDN Name
Definitive
ID