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CMS has made substantial progress on its goal for all people with Traditional Medicare to be in a care relationship with accountability for quality and total cost of care by 2030. As of January 2025, 53.4% of people with Traditional (fee-for-service) Medicare are in an accountable care relationship with a provider. This represents more than 14.8 million people and marks a 4.3 percentage point increase from January 2024, the largest annual increase since CMS began tracking accountable care relationships. This includes patients whose providers are in Accountable Care Organizations (ACOs), including the Medicare Shared Savings Program ACOs and entities participating in Center for Medicare and Medicaid Innovation (Innovation Center) accountable care models, as well as other Innovation Center models focused on total cost of care, advanced primary care, and specialty care.
ACOs are groups of doctors, hospitals, and other health care professionals that work together to give patients high-quality, coordinated service and health care, improve health outcomes, and manage costs.
Steadily increased participation in accountable care arrangements demonstrates that changes CMS has made over the last few years through rulemaking and Innovation Center models are connecting people to longitudinal care relationships with providers. In the calendar year (CY) 2023, CY2024, and CY2025 Physician Fee Schedule final rules, CMS created and then refined the new Advanced Investment Payments (AIP) for new, low-revenue ACOs inexperienced with performance-based risk Medicare ACO initiatives (permanently scaling lessons learned from an Innovation Center model).