ACOs Improve Primary, Preventive Care Delivery for Medicare Beneficiaries

Medicare beneficiaries whose physicians participate in accountable care organizations (ACOs), particularly those taking on financial risk for cost and quality, receive substantially more primary and preventive care than beneficiaries outside of these models, according to new data released by Accountable for Health (A4H).¹

The evidence reinforces the role of value-based care structures in driving early intervention, better chronic disease management, and stronger health outcomes nationwide.

“When providers are accountable for outcomes and not volume, patients get more proactive, coordinated care,” said Mara McDermott, CEO of A4H, in a statement. “Two-sided risk ACOs are doing more than any other traditional Medicare model to ensure beneficiaries receive preventive services that keep them healthier and out of the hospital.”

As policymakers and health system leaders look for sustainable ways to improve care quality while containing costs, ACOs within Medicare continue to demonstrate measurable progress in delivering essential primary and preventive services to older adults. A February 2026 analysis of Medicare claims data from 2019 to 2024 found that beneficiaries attributed to ACOs that assume 2-sided financial risk received higher rates of Medicare Annual Wellness Visits (AWVs) compared with those in ACOs without financial risk and those not aligned with ACOs at all.

ACOs Driving Preventive Care Uptake

AWVs are critical touchpoints in preventive health, allowing clinicians to assess patient health status, identify risk factors, coordinate needed services, and create individualized prevention plans. The A4H data show that by 2024:

• 65% of beneficiaries in 2-sided risk ACOs received an AWV
• 57% of beneficiaries in ACOs without financial risk received an AWV
• 42% of beneficiaries not connected to any ACO received an AWV

These results illustrate how greater ACO accountability correlates with higher utilization of preventive services, an essential driver of long-term health and cost avoidance.

The benefits extend to more medically complex populations as well. Among Medicare beneficiaries who are dually eligible for Medicaid, AWV rates in 2-sided risk ACOs (49%) markedly outpaced those in 1-sided ACOs (37%) and non-ACO groups (26%).

Why ACOs Succeed in Primary and Preventive Care

ACOs are structured around coordinated care, shared accountability, and value-based incentives. By shifting from traditional fee-for-service models—which reimburse per visit or procedure—to frameworks that reward quality and outcomes, ACOs can empower clinicians to emphasize prevention, continuity of care, and proactive management of chronic conditions.² This care model also aligns financial incentives with patient health instead of service volume.

Research shows that ACOs often outperform other care arrangements on quality measures tied to preventive care and chronic disease control. CMS quality benchmarks include diabetes and blood pressure management, cancer screenings, and follow-up care—all programs where ACOs have made gains in recent years.³ Although earlier studies pointed out variation in performance based on organizational structure and primary care adequacy, more recent data consistently find that primary care–centric ACOs tend to deliver stronger quality outcomes and savings relative to other physician group models.⁴

Implications for Medicare Policy and Patient Health

The A4H findings occur amid broader CMS efforts to expand accountable care and incentive alignment in Medicare. As of early 2025, more than half of traditional Medicare beneficiaries were in some form of accountable care relationship—a significant uptick reflecting growth in both Shared Savings Program ACOs and new innovation models focused on advanced primary care and health equity.⁵

Improved access to preventive services translates into earlier detection of disease, more effective chronic condition management, and potentially fewer avoidable hospitalizations. For Medicare, this alignment between quality and cost supports program sustainability, especially in a climate of rising health care needs among aging beneficiaries.¹ For patients, stronger preventive care can mean better health, enhanced quality of life, and greater engagement in managing their own care journey.

Looking Ahead

As Congress and CMS refine payment models and quality incentives, the emerging evidence from Medicare ACO performance suggests that accountable care frameworks can be a foundation for broader system transformation. Enhancing primary care infrastructure, supporting providers in risk-bearing models, and focusing on preventive outcomes could help further improve care equity and long-term health outcomes for millions of Medicare beneficiaries.

“For patients, this means earlier care, better chronic disease management, and fewer avoidable hospital visits,” said McDermott in a statement. “For Medicare, it shows that aligning payment with accountability delivers better care and better value, especially for people with the greatest needs.”

References

1. Data show Medicare ACOs deliver more primary and preventive care. News release. A4H. February 3, 2026. Accessed February 4, 2026. https://accountableforhealth.org/data-show-medicare-acos-deliver-more-primary-and-preventive-care/

2. Coordinating your care. Medicare.gov. Accessed February 4, 2026. https://www.medicare.gov/providers-services/coordinating-care

3. Campbell S, Hobson L. How Medicare ACOs drive clinical quality improvements with APP plus data. HealthCatalyst. Accessed February 4, 2026. https://www.healthcatalyst.com/learn/insights/medicare-acos-clinical-quality-improvements-app-plus-data

4. Greiner A, Del Monte M. Report: primary care centric ACOs generate more savings, better outcomes. Primary Care Collaborative. November 20, 2024. Accessed February 4, 2026. https://thepcc.org/news/report-primary-care-centric-acos-generate-more-savings-better-outcomes/

5. CMS moves closer to accountable care goals with 2025 ACO initiatives. CMS. January 15, 2025. Accessed February 4, 2026. https://www.cms.gov/newsroom/fact-sheets/cms-moves-closer-accountable-care-goals-2025-aco-initiatives