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As of the end of the first quarter of 2017, there were 923 active public and private accountable care organizations (ACOs) in operation, up by 92 over the first quarter of 2016, representing a growth rate of 11%. During 2016, 138 new ACOs began operation, and 46 ACOs dropped their accountable care contracts.

All 50 states, the District of Columbia, and Puerto Rico have at least one ACO. Across all payers, the strongest ACO growth has occurred in hospital referral regions (HRRs) in metropolitan areas, and the most populous states have the most ACOs. Just 15 HRRs are not yet . . .

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