Through the Medicare Annual Wellness Visit (AWV), doctors provide primary care services and make referrals for needed preventive services to their Medicare beneficiary patients. This visit allows the doctor to review health issues and develop or update a personal plan to prevent disease or disability.

Two-sided risk ACOs consistently provide more AWVs to their beneficiaries than ACOs who are only taking on one-sided “upside only” contracts. This means these beneficiaries are more likely to have their chronic conditions better managed, receive preventive services and in general receive more attentive care.

This is particularly important for the Medicare and Medicaid dually eligible population who are more likely to be sicker and need more health care services. Their care is often fragmented and uncoordinated. The two-sided risk ACOs are doing more than any other Traditional Medicare program to address these needs.
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The Shared Savings Program delivered record results in 2024, generating $2.48 billion in net savings while maintaining exceptional quality. Two-sided risk ACOs drove most of the gains, saving $637 per patient. This analysis highlights why accountability works – and how strong policy design can strengthen Medicare’s long-term sustainability.

