Strengthening Healthcare Delivery Through Proactive Primary Care
A stroke can happen without warning. In the months beforehand, however, there may have been a blood pressure reading that needed attention, a prescription that lapsed or a follow-up visit that never got scheduled. Primary care is usually where those signals surface first, and where there is the best chance to act before an emergency.
Much of that work happens between appointments. Care teams review charts ahead of visits, call patients after a hospital discharge and follow up on overdue screenings. Traditional fee-for-service pays for the visit itself but offers little support for the proactive work around it. Value-based care shifts the focus from the volume of services delivered to the quality, outcomes and total cost of care. By aligning financial incentives with prevention, it helps keep patients healthy and out of the hospital while strengthening the long-term financial sustainability of the practice.
How the Medicare Shared Savings Program pays for prevention
For people with traditional Medicare, the Medicare Shared Savings Program (MSSP) enables primary care practices to be paid for that preventive work. MSSP is a permanent, voluntary accountable care program run within traditional Medicare by the Centers for Medicare & Medicaid Services (CMS). Physician groups, health systems and community health centers participate by joining an accountable care organization (ACO), which takes responsibility for the quality and total cost of care for its assigned patients.
Clinicians continue to bill Medicare for covered services under fee-for-service, and MSSP adds a layer of value-based savings on top. When proactive primary care lowers the total cost of patients' care against a historical benchmark, often by preventing avoidable hospitalizations and emergency visits, and the ACO meets quality standards, Medicare shares a portion of those savings with the ACO. Because savings stem directly from keeping people healthy, clinical goals and financial rewards finally pull in the same direction. Shared savings are not guaranteed and depend on multiple factors.
The program operates at significant scale. In performance year 2026, 511 ACOs are serving 12.6 million people with traditional Medicare.¹ In performance year 2024, 75% of participating ACOs earned shared savings, and the program produced roughly $2.5 billion in net savings for Medicare.²
A sustainable model for preventive care
Physician-led value-based care puts primary care physicians and practices at the center of care delivery and decision-making. Shared savings give primary care organizations a revenue stream tied to prevention, which they can reinvest in staff, outreach and technology.
An ACO enablement partner can provide the data, care model support and operational infrastructure needed to identify patient needs, coordinate care and manage the ACO's reporting to Medicare, while participating primary care organizations retain control over how they deliver care. Aledade is one such partner. In fact, practices with five or more years with Aledade deliver approximately three times higher savings than the national average for non-Aledade ACOs of similar tenure.3
With that support and the actionable insights and clinical guidance it brings, primary care teams can reach the right patient at the right time, and the results show up as an emergency visit avoided, a stroke prevented or a hospital stay that never happened. For patients, prevention can mean more birthdays, more holidays and more time with the people they love.
Where Aledade fits
Aledade is a physician-led value-based care company and the leading value-based care participant in MSSP.4 Aledade works alongside primary care organizations to put proactive care into practice through true financial alignment. Within its ACOs, savings are generally allocated approximately 50% to Aledade and 50% to its practice partners, with individual practice distributions weighted by quality performance and other contractual terms.⁵ That means Aledade succeeds only when its primary care partners do.
For more than a decade, Aledade has partnered with thousands of primary care organizations through the ACOs it forms and manages, providing data, technology, care model support and operational infrastructure. Together, these capabilities help clinicians identify patient needs earlier, coordinate care and build a sustainable financial model that helps direct more revenue to primary care. When primary care is financially incentivized to keep patients healthy, warning signs can be caught earlier and life-threatening events can be prevented.
References
1 2026 Medicare Accountable Care Organization Initiatives Participation Highlights, CMS.
2 CMS Proposes Transformational Medicare Reforms to Expand Accountable Care, CMS, July 2026.
3 Aledade analysis of CMS Public Use File of MSSP annual results through 2024; for Aledade data incorporates private CMS data for 2025; weighted average of performance for all data 2015+, incorporates Aledade 2016+ cohorts.
4 Based on internal analysis of data from the 2024 CMS ACO Public Use File.
5 Based on Aledade's standard ACO contractual terms as of January 1, 2026.