$2.5B ACO REACH Results
Beyond the $2.5 Billion:
What ACO REACH’s Results Reveal
The savings made the headline. The operating model behind them may be the more important story.
When CMS released the Performance Year 2024 results for ACO REACH, one number understandably received most of the attention: approximately $2.5 billion in gross savings.
The 115 accountable care organizations participating in the model served approximately 2.5 million Original Medicare beneficiaries and generated nearly $1 billion in net savings for CMS. Gross savings per beneficiary also increased 24 percent compared with the previous year, providing another encouraging signal for a model built around greater accountability for cost, quality, and patient outcomes.
The results are significant, but the larger lesson is not simply that accountable care can reduce spending. For organizations actually doing this work, the more interesting story is what it takes to produce those results consistently.
At AaNeel, that story is particularly meaningful because we have had the opportunity to support ACO REACH organizations with the technology and operational capabilities needed to manage value-based care. Every ACO REACH client supported by AaNeel achieved savings and received shared savings for Performance Year 2024.
We are proud of that result, but we also know the savings belong to the organizations, providers, care teams, and leaders doing the work every day. Our role is to help give those teams the infrastructure and information they need to do that work more effectively.
And that is precisely why the $2.5 billion headline deserves a closer look.
Experience Is Showing Up in the Results
One of the more important signals within the 2024 results is the relationship between experience and performance.
CMS reported that gross savings per beneficiary increased by 24 percent compared with the previous year, and organizations with greater experience in the model generally demonstrated stronger results. That reinforces something healthcare leaders working in accountable care already understand: value-based care performance develops over time.
A contract can establish financial accountability immediately, but operational maturity cannot be created overnight. Organizations learn their populations. Care management workflows become more sophisticated. Provider engagement strengthens. Teams learn which interventions are actually changing outcomes and which are simply creating activity. Risk identification becomes more precise, and organizations become better at directing limited resources toward the patients who need them most.
None of that happens because an organization signs a value-based contract. It happens because the organization builds an operating model capable of supporting the contract.
Savings Are Only Part of the Story
The financial results understandably dominate the conversation, but Performance Year 2024 also showed progress beyond savings. Quality scores improved, timely follow-up after hospitalization increased, and participating organizations continued focusing on avoidable hospital utilization, primary care engagement, and support for beneficiaries with complex health needs.
Those measures matter because the objective of accountable care has never been to spend less. The objective is to create a healthcare system capable of delivering better outcomes while using resources more effectively.
Achieving both requires a very different operating environment from traditional fee-for-service healthcare. ACOs need to understand what is happening across their populations, identify emerging needs earlier, coordinate across providers and settings, and intervene. At the same time, there is still an opportunity to influence an outcome.
Financial accountability may define the model, but operational capability determines how an organization performs within it.
The Operating Model Behind the Financial Model
ACO REACH creates accountability across a patient’s broader healthcare journey. Operationally, however, that journey may involve a primary care physician, several specialists, a hospital, a skilled nursing facility, a pharmacy, home-based services, and numerous other touchpoints.
Every encounter creates information that could influence the next decision. The challenge is ensuring that information reaches the right people while remaining useful.
A hospitalization identified weeks later can help explain utilization, while a hospitalization visible quickly enough to trigger transitional care can potentially influence what happens next. A care gap discovered in a retrospective report can contribute to measurement, while the same gap identified with enough time to intervene becomes a care management opportunity.
Accountable care becomes considerably harder when accountability moves faster than information.
This is where connected data becomes part of the basic infrastructure of value-based care. Organizations need visibility into admissions, discharges, medications, diagnoses, care gaps, utilization patterns, and changes in patient risk. More importantly, they need workflows that determine what happens when those signals appear.
Data Without Action Is Still Just Data
Healthcare has invested heavily in its ability to collect and analyze information. The harder work is operationalizing it.
An organization can identify a high-risk patient perfectly and still experience an avoidable hospitalization if nobody acts on the insight. A discharge notification can arrive immediately and provide little value if there is no established workflow for follow-up. A provider can receive more complete patient information and still struggle if it arrives outside the normal clinical workflow or without enough context to support a decision.
That is why technology alone cannot produce accountable care performance.
Strong organizations build operational structures around their information. They establish which signals require action, who owns the response, how quickly follow-up should occur, when providers need to become involved, and how the outcome will be measured.
Care coordination teams are particularly important in that process because they often sit at the point where information becomes action. They connect patients to services, communicate across care settings, support providers, monitor changes in risk, and help ensure that an insight discovered in the data reaches someone who can do something with it.
Technology can make the information available. The operating model determines whether that information changes care.
What Our ACO REACH Clients Reinforced for Us
The national results tell an encouraging story about ACO REACH. Our experience supporting organizations participating in the model gives us another perspective on what sits underneath those numbers.
Every AaNeel-supported ACO REACH client achieved savings and received shared savings for Performance Year 2024. While each organization’s performance reflects the work of its leadership, providers, care teams, and partners, their results reinforce the importance of having the right operational infrastructure behind a value-based care strategy.
Successful accountable care requires more than access to technology. It requires technology that supports the operating model.
Data has to be accessible enough to inform decisions. Workflows have to translate information into action. Care teams need visibility into patient needs across the continuum. Providers need useful information without additional administrative friction. Leadership needs enough insight to understand performance while there is still time to influence it.
No technology company should claim responsibility for the work an ACO and its providers do to achieve shared savings. But technology should make that work easier to execute, measure, and improve.
That is the standard we believe healthcare technology should be held to.
Beyond the Headline
The Performance Year 2024 ACO REACH results provide encouraging evidence for the continued evolution of accountable care. They also reinforce that success is not created by the financial model alone.
The organizations producing sustainable results are building capabilities underneath the contract. They are strengthening provider engagement, improving care coordination, refining workflows, identifying risk earlier, connecting information across settings, and learning from one performance year to the next.
For ACO leaders, the question is therefore becoming more sophisticated. It is no longer simply whether accountable care can generate results. The evidence increasingly suggests that it can. The more important question is whether an organization has built the infrastructure required to generate those results consistently.
Does information move quickly enough to support decisions? Are providers aligned around the model? Can care teams identify emerging needs and respond? Are workflows designed around action rather than reporting? Can the organization learn from each performance year and become better at managing the next one?
Value-based care is not simply a contract an organization signs. It is an operating model that must be built, supported, measured, and continuously improved.
The $2.5 billion may have made the headline. What happened underneath that number is where the more important story begins.
Read the original Healthcare Innovation article:
In Performance Year 2024, REACH ACOs Generated $2.5 Billion in Savings
