Improving the Health Landscape Begins with Incentivizing Preventive Care

For decades, healthcare has been built around one central question: “How can I treat your condition today?”

In a traditional fee-for-service model, physicians are rewarded for the services they provide and the number of patients they see. Patients may receive care only after experiencing expensive acute events, like heart attacks or strokes. This leaves physicians with little time and too few resources to address how those health emergencies could have been prevented.

Value-based care asks a different, more proactive question: “How can we keep you healthy for a better tomorrow?”

To fundamentally transform Traditional Medicare, we must change how we pay for primary care. When financial incentives move away from volume and align with high-quality, proactive preventive care, everyone benefits. Physicians can spend more time with patients, building trust, identifying risks earlier and helping to prevent unnecessary hospital and emergency department (ED) visits. Aligning payment with health outcomes helps primary care practices remain financially viable while giving Medicare patients more quality years with their loved ones.

From volume to value: How the Medicare Shared Savings Program (MSSP) works

This proactive value-based framework is grounded in federal statute. The Medicare Shared Savings Program (MSSP) is a permanent, voluntary accountable care program run within Traditional Medicare by the Centers for Medicare & Medicaid Services (CMS). When proactive primary care successfully reduces the total cost of the patient’s care (compared to a historical benchmark) by preventing avoidable hospitalizations and emergency visits, Medicare returns those savings back to those practices who are participating through an accountable care organization (ACO).

Recent CMS data shows that MSSP continues to accelerate:

• MSSP now includes 511 ACOs representing more than 700,000 healthcare providers and organizations caring for 12.6 million Traditional Medicare patients for performance year 2026 — a 12.3% increase from 2025 and the largest number ever served by the program.¹
• In the largest single-year jump in CMS history, 53.4% of Traditional Medicare beneficiaries (more than 14.8 million people) were aligned with an ACO as of January 2025.²

Why MSSP is the perfect match for primary care

Primary care physicians (PCPs) are uniquely positioned to be the foundation of value-based care. They have a unique perspective into a patient’s overall health picture, enabling them to focus on early detection, chronic disease management and hospital diversion. The natural stewards of total cost and quality, PCPs are already poised to take care of the “whole patient.” Value-based care recognizes this foundational role and aligns payment with the preventive care PCPs already deliver.

MSSP ACOs lowered costs to Medicare by an estimated $2.9 billion in the first eight years of the program alone.³ The results also show a clear performance advantage for physician-led care. CMS distinguishes between low-revenue ACOs, which are typically physician-led and primary-care-driven, and high-revenue ACOs, which are typically health system-led. In performance year 2024, physician-led ACOs generated $319 in net per capita savings compared to $180 for hospital-led ACOs, highlighting that independent primary care can return the strongest returns in value-based care.⁴

Aledade’s physician-led ACOs are top-performing, creating a sustainable model for primary care organizations to remain open and care for their patients, with 93% of our ACOs achieving savings in 2024, compared to 73% among non-Aledade participants.⁵

A public benefit corporation, Aledade partners with more than 3,000 primary care organizations in 46 states and D.C.,⁶ helping them succeed in value-based care. We don’t own clinics — we empower them with data, technology, support and proven strategies to keep patients healthy and to help physicians thrive financially.

For over a decade, we’ve partnered with thousands of primary care organizations through our ACOs to help millions of patients share in the reward of better health. We’re just getting started. Let’s strengthen primary care together.

For direct support in navigating MSSP options, connect with Aledade today.

References

1. 2026 Medicare Accountable Care Organization Initiatives Participation Highlights
2. CMS Moves Closer to Accountable Care Goals with 2025 ACO Initiatives.
3. Streat DA, Broome T, Chiglinsky B, Mostashari F. More than "beating the benchmark": 5 Medicare ACOs, 2015-2019. Am J Accountable Care. 2021;9(3):4-9. doi:10.37765/ajac.2021.88747.
4. Medicare Shared Savings Program Accountable Care Organization Updated Performance Year 2024 Financial and Quality Results, 2025.
5. Based on internal analysis of data from the 2024 CMS ACO Public Use File, available here. Past performance is not indicative of future performance. Shared savings not guaranteed. The individual performance of non-Aledade ACOs may be better or worse than average.
6. Scale as of 3/31/2026