For nearly two decades, Better Health Group has been a leader in value-based care and operating top-rated primary care clinics. Our network of owned and independent clinics leverage our model to improve care for both Medicare Advantage (MA) and Traditional Medicare patients. Now, the Centers for Medicare & Medicaid Services (CMS) has ranked Better Health Group in the top 5% of Medicare Shared Savings Program (MSSP), Accountable Care Organizations (ACOs) for performance year 2023.
At a time when independent clinics face mounting challenges, our providers are exceeding CMS quality goals and maximizing shared savings revenue, in every state in which we operate—Florida, Alabama, Georgia, Texas, Oklahoma, and Tennessee.
How to Read Your ACO Performance Report — Without Needing a Decoder Ring
If you've ever opened your ACO performance report and closed it again without being entirely sure what you were looking at, you're not alone. These documents contain some of the most important financial and quality data about your entire ACO’s performance in the previous performance year.
Here's a plain-language breakdown of what each section actually means and what to pay attention to.
What an ACO Performance Report Is
Your ACO performance report is the document CMS produces usually at the end of a performance year that summarizes how your ACO performed against its benchmark and quality targets. It's what determines whether your practice receives a shared savings distribution and, if so, how much.
Think of it as your practice's report card for value-based care. The difference is that this report card has direct financial consequences.
The Benchmark: The Number Everything Else Flows From
The most important number in your performance report is the benchmark — the dollar figure representing what CMS expected your attributed Medicare population to cost during the performance year.
CMS calculates this based on the historical spending of your specific attributed patients, adjusted for regional cost trends and patient complexity. If your actual spending came in below this number by enough to clear the Minimum Savings Rate, your ACO generated shared savings. If it came in above, no savings were generated — and in the Enhanced Track, you may be looking at shared losses.
When you're reading your report, the benchmark is the baseline. Everything else is measured against it.
Actual Expenditures: What Your Patients Actually Cost
This is the total Medicare spending for your attributed patient population during the performance year across all settings including hospitalizations, specialist visits, emergency department use, outpatient procedures and pharmacy.
The gap between your actual expenditures and your benchmark is the number that matters. A positive gap (spending below benchmark) means potential savings. A negative gap means spending exceeded expectations. As a result of Better Health Group’s proven model, clinics are achieving top-tier HEDIS and Star Ratings and achieving average gains of over $1,000 per patient
One thing worth noting: you don't control all of this spending. A patient hospitalized for a major cardiac event is going to generate significant expenditure. What you can influence is the chronic disease management, preventive care and care coordination that reduces avoidable utilization over time such as ED visits for conditions that could have been managed in-office, hospitalizations that a proactive follow-up might have prevented, and specialist referrals that weren't necessary.
Quality Score: The Gate You Have to Clear
Shared savings aren't paid out on the basis of cost performance alone. Your ACO also has to meet a quality performance threshold and the quality score in your report is what determines whether you cleared it.
CMS measures ACO quality across several domains, including preventive care delivery, management of chronic conditions like diabetes and hypertension, and patient experience. These map to specific measures like HEDIS metrics, patient survey results and claims-based quality indicators that ACOs report on annually.
In BHG's network, the average quality score across our ACOs was 85.7% in Performance Year 2024 compared to the national ACO average of 81.9%. That gap represents years of systematic attention to care gap closure, coding accuracy and quality documentation. If your quality score is below the threshold, you won't receive a shared savings distribution regardless of how your cost performance looks.
Attribution: Who's Actually in Your Population
Your performance report will include data on your attributed patient population — the Medicare beneficiaries CMS has assigned to your ACO based on where they received most of their primary care services.
Attribution can shift year over year. Patients who see you less frequently, or who establish care with another provider, may fall out of your attributed population. Patients who are new to your practice or see you more consistently may be added.
Why does this matter? Because your benchmark is calculated based on your attributed population. A significant shift in attribution — especially if higher-cost patients leave or lower-cost patients enter — can move your benchmark and your actual expenditures in ways that affect your shared savings calculation independently of how you practice.
Understanding who is attributed to your practice, and monitoring changes over time, is one of the most practical things you can do to manage your ACO performance proactively.
Per-Capita Cost Breakdown: Where the Spending Is
Most performance reports break down your attributed population's spending by category: inpatient, outpatient, emergency department, post-acute care and so on. This is where you can start to identify the levers.
If your inpatient spending is significantly above benchmark, that points to hospitalization patterns, which are often tied to gaps in chronic disease management or care coordination. If your ED spending is high, that may indicate patients seeking care outside your office for conditions that could be managed in a primary care setting. Post-acute spending tied to skilled nursing facilities is often a sign that discharge planning and follow-up care could be stronger.
These per-capita breakdowns are the most actionable part of your report. They tell you not just how you did, but where the opportunities are in the year ahead.
The Bottom Line: Your Report Is a Planning Tool, Not Just a Scorecard
Most practices treat their ACO performance report as a look backward and ask “Did we earn shared savings or not?” The more useful way to read it is as a planning document for the next performance year and decide whether you want to stay in your current ACO or join another ACO who can help you maximize your performance.
Where did spending exceed expectations? Which quality measures are you closest to improving? How did your attributed population change, and what does that mean for your benchmark? A good ACO partner doesn't just send you the report — they sit down with you and work through what it means and what to do differently.
That's the practical difference between participating in an ACO and actually performing in one.
How to Read Your ACO Performance Report — Without Needing a Decoder Ring
If you've ever opened your ACO performance report and closed it again without being entirely sure what you were looking at, you're not alone. These documents contain some of the most important financial and quality data about your entire ACO’s performance in the previous performance year.
Here's a plain-language breakdown of what each section actually means and what to pay attention to.
What an ACO Performance Report Is
Your ACO performance report is the document CMS produces usually at the end of a performance year that summarizes how your ACO performed against its benchmark and quality targets. It's what determines whether your practice receives a shared savings distribution and, if so, how much.
Think of it as your practice's report card for value-based care. The difference is that this report card has direct financial consequences.
The Benchmark: The Number Everything Else Flows From
The most important number in your performance report is the benchmark — the dollar figure representing what CMS expected your attributed Medicare population to cost during the performance year.
CMS calculates this based on the historical spending of your specific attributed patients, adjusted for regional cost trends and patient complexity. If your actual spending came in below this number by enough to clear the Minimum Savings Rate, your ACO generated shared savings. If it came in above, no savings were generated — and in the Enhanced Track, you may be looking at shared losses.
When you're reading your report, the benchmark is the baseline. Everything else is measured against it.
Actual Expenditures: What Your Patients Actually Cost
This is the total Medicare spending for your attributed patient population during the performance year across all settings including hospitalizations, specialist visits, emergency department use, outpatient procedures and pharmacy.
The gap between your actual expenditures and your benchmark is the number that matters. A positive gap (spending below benchmark) means potential savings. A negative gap means spending exceeded expectations. As a result of Better Health Group’s proven model, clinics are achieving top-tier HEDIS and Star Ratings and achieving average gains of over $1,000 per patient
One thing worth noting: you don't control all of this spending. A patient hospitalized for a major cardiac event is going to generate significant expenditure. What you can influence is the chronic disease management, preventive care and care coordination that reduces avoidable utilization over time such as ED visits for conditions that could have been managed in-office, hospitalizations that a proactive follow-up might have prevented, and specialist referrals that weren't necessary.
Quality Score: The Gate You Have to Clear
Shared savings aren't paid out on the basis of cost performance alone. Your ACO also has to meet a quality performance threshold and the quality score in your report is what determines whether you cleared it.
CMS measures ACO quality across several domains, including preventive care delivery, management of chronic conditions like diabetes and hypertension, and patient experience. These map to specific measures like HEDIS metrics, patient survey results and claims-based quality indicators that ACOs report on annually.
In BHG's network, the average quality score across our ACOs was 85.7% in Performance Year 2024 compared to the national ACO average of 81.9%. That gap represents years of systematic attention to care gap closure, coding accuracy and quality documentation. If your quality score is below the threshold, you won't receive a shared savings distribution regardless of how your cost performance looks.
Attribution: Who's Actually in Your Population
Your performance report will include data on your attributed patient population — the Medicare beneficiaries CMS has assigned to your ACO based on where they received most of their primary care services.
Attribution can shift year over year. Patients who see you less frequently, or who establish care with another provider, may fall out of your attributed population. Patients who are new to your practice or see you more consistently may be added.
Why does this matter? Because your benchmark is calculated based on your attributed population. A significant shift in attribution — especially if higher-cost patients leave or lower-cost patients enter — can move your benchmark and your actual expenditures in ways that affect your shared savings calculation independently of how you practice.
Understanding who is attributed to your practice, and monitoring changes over time, is one of the most practical things you can do to manage your ACO performance proactively.
Per-Capita Cost Breakdown: Where the Spending Is
Most performance reports break down your attributed population's spending by category: inpatient, outpatient, emergency department, post-acute care and so on. This is where you can start to identify the levers.
If your inpatient spending is significantly above benchmark, that points to hospitalization patterns, which are often tied to gaps in chronic disease management or care coordination. If your ED spending is high, that may indicate patients seeking care outside your office for conditions that could be managed in a primary care setting. Post-acute spending tied to skilled nursing facilities is often a sign that discharge planning and follow-up care could be stronger.
These per-capita breakdowns are the most actionable part of your report. They tell you not just how you did, but where the opportunities are in the year ahead.
The Bottom Line: Your Report Is a Planning Tool, Not Just a Scorecard
Most practices treat their ACO performance report as a look backward and ask “Did we earn shared savings or not?” The more useful way to read it is as a planning document for the next performance year and decide whether you want to stay in your current ACO or join another ACO who can help you maximize your performance.
Where did spending exceed expectations? Which quality measures are you closest to improving? How did your attributed population change, and what does that mean for your benchmark? A good ACO partner doesn't just send you the report — they sit down with you and work through what it means and what to do differently.
That's the practical difference between participating in an ACO and actually performing in one.
How to Read Your ACO Performance Report — Without Needing a Decoder Ring
If you've ever opened your ACO performance report and closed it again without being entirely sure what you were looking at, you're not alone. These documents contain some of the most important financial and quality data about your entire ACO’s performance in the previous performance year.
Here's a plain-language breakdown of what each section actually means and what to pay attention to.
What an ACO Performance Report Is
Your ACO performance report is the document CMS produces usually at the end of a performance year that summarizes how your ACO performed against its benchmark and quality targets. It's what determines whether your practice receives a shared savings distribution and, if so, how much.
Think of it as your practice's report card for value-based care. The difference is that this report card has direct financial consequences.
The Benchmark: The Number Everything Else Flows From
The most important number in your performance report is the benchmark — the dollar figure representing what CMS expected your attributed Medicare population to cost during the performance year.
CMS calculates this based on the historical spending of your specific attributed patients, adjusted for regional cost trends and patient complexity. If your actual spending came in below this number by enough to clear the Minimum Savings Rate, your ACO generated shared savings. If it came in above, no savings were generated — and in the Enhanced Track, you may be looking at shared losses.
When you're reading your report, the benchmark is the baseline. Everything else is measured against it.
Actual Expenditures: What Your Patients Actually Cost
This is the total Medicare spending for your attributed patient population during the performance year across all settings including hospitalizations, specialist visits, emergency department use, outpatient procedures and pharmacy.
The gap between your actual expenditures and your benchmark is the number that matters. A positive gap (spending below benchmark) means potential savings. A negative gap means spending exceeded expectations. As a result of Better Health Group’s proven model, clinics are achieving top-tier HEDIS and Star Ratings and achieving average gains of over $1,000 per patient
One thing worth noting: you don't control all of this spending. A patient hospitalized for a major cardiac event is going to generate significant expenditure. What you can influence is the chronic disease management, preventive care and care coordination that reduces avoidable utilization over time such as ED visits for conditions that could have been managed in-office, hospitalizations that a proactive follow-up might have prevented, and specialist referrals that weren't necessary.
Quality Score: The Gate You Have to Clear
Shared savings aren't paid out on the basis of cost performance alone. Your ACO also has to meet a quality performance threshold and the quality score in your report is what determines whether you cleared it.
CMS measures ACO quality across several domains, including preventive care delivery, management of chronic conditions like diabetes and hypertension, and patient experience. These map to specific measures like HEDIS metrics, patient survey results and claims-based quality indicators that ACOs report on annually.
In BHG's network, the average quality score across our ACOs was 85.7% in Performance Year 2024 compared to the national ACO average of 81.9%. That gap represents years of systematic attention to care gap closure, coding accuracy and quality documentation. If your quality score is below the threshold, you won't receive a shared savings distribution regardless of how your cost performance looks.
Attribution: Who's Actually in Your Population
Your performance report will include data on your attributed patient population — the Medicare beneficiaries CMS has assigned to your ACO based on where they received most of their primary care services.
Attribution can shift year over year. Patients who see you less frequently, or who establish care with another provider, may fall out of your attributed population. Patients who are new to your practice or see you more consistently may be added.
Why does this matter? Because your benchmark is calculated based on your attributed population. A significant shift in attribution — especially if higher-cost patients leave or lower-cost patients enter — can move your benchmark and your actual expenditures in ways that affect your shared savings calculation independently of how you practice.
Understanding who is attributed to your practice, and monitoring changes over time, is one of the most practical things you can do to manage your ACO performance proactively.
Per-Capita Cost Breakdown: Where the Spending Is
Most performance reports break down your attributed population's spending by category: inpatient, outpatient, emergency department, post-acute care and so on. This is where you can start to identify the levers.
If your inpatient spending is significantly above benchmark, that points to hospitalization patterns, which are often tied to gaps in chronic disease management or care coordination. If your ED spending is high, that may indicate patients seeking care outside your office for conditions that could be managed in a primary care setting. Post-acute spending tied to skilled nursing facilities is often a sign that discharge planning and follow-up care could be stronger.
These per-capita breakdowns are the most actionable part of your report. They tell you not just how you did, but where the opportunities are in the year ahead.
The Bottom Line: Your Report Is a Planning Tool, Not Just a Scorecard
Most practices treat their ACO performance report as a look backward and ask “Did we earn shared savings or not?” The more useful way to read it is as a planning document for the next performance year and decide whether you want to stay in your current ACO or join another ACO who can help you maximize your performance.
Where did spending exceed expectations? Which quality measures are you closest to improving? How did your attributed population change, and what does that mean for your benchmark? A good ACO partner doesn't just send you the report — they sit down with you and work through what it means and what to do differently.
That's the practical difference between participating in an ACO and actually performing in one.