44 ACOs to know
Accountable care organizations, or ACOs, are physician- and health system-led groups that ascertain and apply savings in healthcare delivery. These organizations often work in partnership with Medicare programs, while also providing care for private insurance patients.
Each year, ACOs save patients and health systems alike millions of dollars. Ultimately, their goal is to provide excellent patient care at a lower cost. Many of the listed ACOs are among the first adopters of the Medicare Shared Savings Program.
Note: This list is not exhaustive, nor is it an endorsement of included ACOs. ACOs cannot pay for inclusion on this list. ACOs are presented in alphabetical order. We extend a special thank you to Rhoda Weiss for her contributions to this list.
Contact Anna Falvey at afalvey@beckershealthcare.com with questions or comments.
AdvantagePoint Health Alliance (Brentwood, Tenn.). AdvantagePoint Health Alliance, a clinically integrated network led by providers in tandem with Lifepoint Health, drives value-based care initiatives. The organization now boasts eight networks across the nation, more than doubling since 2019. The ACO has transitioned from an arbitrage model to the utilization of data- and analytics-based targeted resources. In addition, the organization applies a dedicated RN model for Medicare annual wellness visits, offers pre- and post-encounter clinical documentation integrity support for ambulatory care, and has expanded its high-functioning post-acute networks. In the coming year, the ACO plans to deploy clinical documentation integrity resources across remaining networks, implement point-of-care support questionnaires to streamline provider workflow, begin offering post-encounter reviews for diagnostic accuracy, earn shared savings through care coordination, and much more.
Advocate Health (Charlotte, N.C.). Advocate Health’s ACOs earned a No. 1 spot among integrated delivery networks participating in the Medicare Shared Savings Program, collectively producing $128.2 million in total savings through the program in 2022. Since joining the program in 2012, the ACOs have saved taxpayers nearly a billion dollars and provided top-tier patient care. Advocate Health has six ACOs: Advocate Physician Partners ACO, Aurora ACO, Carolinas Physician Alliance, TC2, CHESS Innovation and CHESS Value.
Arkansas Health Network (Little Rock). Arkansas Health Network is a physician-driven, clinically integrated network serving more than 138,000 patients. The ACO was established in 2013 as part of Chicago-based CommonSpirit Health. The ACO, committed to value-based care, is a major driver of quality, health and financial improvement for patients and providers. Since 2014, the ACO has saved Medicare over $58 million in medical spending, with $4.7 million in earned Medicare Shared Savings Program savings in 2021. In March 2023, the organization earned dual accreditation in clinical integration and employer based population health, making it the first clinically integrated network in the industry to do so.
Atlantic Accountable Care Organization (Morristown, N.J.). As one of the first ACOs established from the inception of the Medicare Shared Savings Program, the Atlantic ACO has consistently saved Medicare money each year. It is composed of over 2,000 associated physicians across five participating hospitals. Looking to the future, the ACO aims to expand its behavioral health programs.
Banner Health Network (Phoenix). Beneficiaries of Banner Health Network receive quality care and preventive medicine, resulting in less cost to Medicare. Serving over 400,000 members and beneficiaries, the ACO has saved millions of dollars since its inception. Banner Health Network consists of 5,000 affiliated physicians and advanced practice providers across 15 hospitals, eight health centers and multiple other medical facilities. The ACO aims to use technology to continue improving the patient and provider experience.
Baptist Physician Partners (Jacksonville, Fla.). Since its inception in 2014, Baptist Physician Partners has generated just over $125 million in total savings via its value-based agreements. The organization first became an ACO through the Medicare Shared Savings Program in 2018. By 2021, it was ranked in the 4% for total savings as compared to all participating ACOs. Since then, the program has recruited 1,150 physician members and garnered 88,000 covered lives. The ACO has also enhanced and broadened its home-based care model, set in place a leadership structure for its palliative care initiative, created a population health transformation team, shifted care coordination to a regional model, launched a remote monitoring strategy for patients with diabetes and hypertension, moved Baptist Health system to Epic EHR and much more. Moving forward, the ACO aims to expand the nine enhanced home-based models, broaden the serious illness management and advocacy program, increase the scope of the skilled nursing facility at home model, and develop a standardized model aimed at enhancing patient experience across 50 primary care offices.
BayCare Physician Partners (Clearwater, Fla.). BayCare Physician Partners is BayCare Health System’s ACO. Over the past two years, the ACO has attained an overall quality score of 84.8%, earning it a spot in the top 33% of ACOs nationwide. The network also earned a savings rate of 6.21%, making it one of the top 25% of all ACOs. Overall, the ACO has brought about more than over $31 million in shared savings for Medicare. In the coming year, the ACO wants to implement a population health analytics platform, improve the accuracy and completeness of clinical documentation, and shift the care management process from reactive to proactive, among other goals. The ACO is led by Xavier Sevilla, MD, who also serves as chief medical officer of population health at BayCare Health System.
Baylor Scott & White Quality Alliance (Dallas). Baylor Scott & White Quality Alliance is an ACO as well as a clinically integrated network affiliated with Baylor Scott & White Health. It serves more than 1 million members and is committed to delivering its patients the highest quality, cost-effective care possible. The Alliance’s provider network is composed of more than 6,000 physicians, 50 hospitals, 95 post-acute care facilities and other healthcare stakeholders.
Boston Accountable Care Organization. A part of Boston Medical Center Health System, Boston Accountable Care Organization manages coordinated care for 200,000 patients, Medicaid, Medicare and commercial payers. Throughout the past two years, the ACO has launched initiatives to expand virtual consult services, enhance primary care, and support those with nutritional and housing needs. In 2022 alone, the ACO was able to reach more than 2,100 patients via 1,300 nutritional support services and over 250 housing-specific support services. The ACO takes a data-driven approach to care, factoring in key social factors to improve overall health equity and outcomes. Between 2018 and 2023, BACO increased health-related social needs screenings by 80%. They increased screening for depression and follow up planning by 19% and saw a 38% increase in depression remission or treatment response amongst patients. In addition, the ACO partnered with Sprinter Health to develop at-home testing programs and implemented text-messaging programs to benefit patients.
Community Care of Brooklyn (N.Y.) IPA. Community Care of Brooklyn IPA connects clinical networks with managed care and community-based service providers in order to offer comprehensive health and social care. The network, founded in 2018, features almost 100 organizations serving more than 85,000 beneficiaries. Community Care of Brooklyn comprises seven hospitals, five federally qualified health centers, primary care physicians, behavioral health providers, and various other healthcare entities all seeking to advance health equity and reduce total costs. The ACO is now aiming to embed care management into participating practices, expand Medicaid recipient access to social care services, connect patients to existing care provision networks and infrastructure, improve clinical outcomes through increased rates of annual wellness visits and preventative screenings, and much more.
Covenant ACO (Lubbock, Texas). Covenant ACO serves upwards of 13,000 Medicare beneficiaries, and features nearly 600 physicians and advanced practice providers. The ACO, established in 2014, saves money via coordinated, consistent care. In 2022, the ACO generated nearly $11 million in savings to the Medicare Shared Savings Program, making 2022 the third consecutive year that they outdid their previous year’s financial performance.
HMH ACO (Edison, N.J.). Hackensack Meridian Health’s three ACOs, HackensackAlliance ACO, JFK Health ACO and Meridian Health ACO, combined in 2023 to form HMH ACO. The organization currently has over 1,300 providers providing care for almost 60,000 beneficiaries. The three ACOs, before combining into HMH ACO, had gleaned $247 million in combined total savings from 2012 to 2021. This year, the ACO is trying to reduce the per capita cost of healthcare via improved care outcomes, experience and access. The ACO executive for HMH ACO is William Oser, MD.
Health Connect Partners (Renton, Wash.). Founded in 2014, Providence’s Health Connect Partners, a Medicare Shared Savings Program ACO, serves more than 119,000 beneficiaries in the Western U.S and is the seventh largest MSSP ACO in the country. In 2022, HCP generated more than $98 million in savings to the CMS, more than any other MSSP in the same year. Since its inception, HCP steadily improved performance, delivering increasing CMS savings in multiple years including 2017, and 2019 through 2022. This success is largely attributed to HCP leveraging the high quality and efficient work of physicians within the Providence family of organizations, maximizing outcomes for both patient care, and CMS and Medicare savings.
Healthier Communities ACO (Suffern, N.Y.). Founded in 2020, Healthier Communities ACO aims to assist providers in meeting quality and efficiency requirements and making the most of the incentives. The ACO was created by Westchester Medical Center Health Network and its Bon Secours Medical Group to provide high quality, coordinated care and reduce costs to Medicare fee-for-service patients. The ACO is currently under a five-year renewable contract with CMS and is led by Michele Muldoon.
Ilumed (Jupiter, Fla.). Ilumed is an ACO REACH organization dedicated to caring for 74,000-plus Medicare beneficiaries spanning 14 states. The organization, run by CEO Debra Finnel, has implemented a new data-tracking system for the member-outreach team in order to execute 72-hour hospital discharge follow-ups. These check-ins have been crucial in preventing readmissions and ultimately led to over $2.6 million in savings. Over the past two years, an AI platform partnership has been launched to help the clinical team analyze patients’ claims data. According to a study looking at the impact of this partnership, Ilumed has saved about $3 million a year from prevented escalations and admissions. In 2022, CMS ranked Ilumed in the top ten for cost savings of all companies in the DCE/ACO REACH program. Looking to the future, the program wants to address food insecurity in underserved communities and increase partnerships with independent physicians.
Innovation Care Partners (Scottsdale, Ariz.). Innovation Care Partners is both an ACO and a clinically integrated network, owned by HonorHealth. The organization, established in 2012, provides value-based care to over 175,000 patients via more than 2,000 physician members. The ACO benefits its patients by upping the quality of care, tailoring care to individual patients, eliminating unnecessary testing, utilizing care coordinators to assist patients in maneuvering the healthcare system, and more.
Keystone ACO (Danville, Pa.). Keystone ACO works with physicians, hospitals and various other healthcare providers to offer improved, coordinated patient care. The network comprises nine hospitals in the area, as well as 18 physician practices. The ACO was established in 2013 and features over 4,500 doctors and providers. The organization serves 78,000 Medicare beneficiaries, offering better and more affordable care services to improve population health. The ACO coordinates with primary care doctors, nurse case managers, pharmacists and specialists to offer patients the best possible care.
LTC ACO (Kennett Square, Pa.). LTC ACO, the first ACO to serve Medicare beneficiaries living in long-stay care facilities, prioritizes the needs of older individuals, those living with Alzheimer’s disease or dementia, depression, amputations, disabilities, renal failure, or chronic diseases and complications. The organization offers value-based care rooted in actionable data and insights that improve quality and affordability. Uniquely, the program’s partner practices have no downside risk and do not need capital contribution to participate.
Loudoun Medical Group (Leesburg, Va.). Loudoun Medical Group aspires to provide high quality, cost efficient care to its patients while growing as an independent group practice. Throughout the past two years, the organization has established advanced imaging services to provide affordable, accredited computed tomography services outside of the hospital setting. In addition, the organization has reduced costs for more than 422,000 patients. Loudoun Medical Group also partnered to launch The Williams Center for Wellness and Recovery to enhance mental health and reduce the burden of care on primary care providers. The organization also recently opened LMG Family Medicine, LMG Internal Medicine, LMG Interventional Radiology and Stone Springs MedSpa by LMG, among other services.
Mass General Brigham ACO (Somerville, Mass.). Mass General Brigham ACO was established in April 2023. Since then, it has onboarded more than 140,000 members. An integrated plan was put in place during the transition, ensuring that resources were available to those at risk of losing Medicaid coverage. The ACO has enrolled 70% of ACO membership in a secure electronic portal to guarantee connectivity and effective communication. Using a coordinated care model, the ACO has focused not only on physical health but also mental health outreach. The organization looks to support an approved federal waiver to expand continuous eligibility for certain Medicaid populations, with a focus on health-related social needs and health equity efforts.
Mayo Clinic Community ACO (Rochester, Minn.). Founded in July 2019, Mayo Clinic Community ACO includes Mayo Clinic’s flagship campus and all Mayo Clinic Health System locations throughout Minnesota and Wisconsin. Mayo, already an early adopter of value-based care, was well-suited to participate in transformative ACO initiatives that are moving the industry towards pay for value and Medicare sustainability. The ACO is led by ACO executive Kristin Johnson.
MemorialCare Medical Foundation (Fountain Valley, Calif.). With more than 2,000 employed and contracted physicians, MemorialCare Medical Foundation provides HMO, PPO and direct-to-employer services to approximately 56,000 beneficiaries in its contracting with several ACO arrangements. These include Aetna, Blue Shield, Primary Care First, Centivo and The Boeing Company. Its multi-year successful direct-to-employer relationship with Boeing stands as California’s first significant direct-to-employer population health management model, demonstrating continued cost savings and exceeding clinical and patient satisfaction benchmarks.
Mercy ACO (Chesterfield, Mo.). Mercy’s Medicare Shared Savings Program ACO has saved CMS beneficiaries over $125 million over the span of the past two years. During the same timeframe, the ACO achieved top decile performance in quality measures, including management of complex conditions, access to primary, specialty and acute care, and patient satisfaction measures. In the 2022 calendar year, the ACO reached the highest level of quality outcomes as compared to the top 15 ACOs across the country, based on total attributed beneficiaries. The ACO is overseen by a multi-discipline Mercy ACO board comprising caregivers, a Medicare beneficiary and operational leaders. The program is committed to optimal quality, optimal cost performance and best-in-class patient experience.
Mercy Health Select (Cincinnati). Boasting over 107,000 Medicare beneficiaries and 6,000 providers, Mercy Health Select has recently added 1,400 new providers and 30,000 new beneficiaries. With over $85.6 million in savings for CMS and earned shared savings of $62.9 million, the ACO was one of the top 10 ACOs for earned shared savings in both 2021 and 2022. It was one of just a few ACOs able to successfully submit electronic clinical quality measures for 2023 quality reporting. This year, the ACO is working to improve patient outcomes, experience and cost through the optimization of progressive programs like skilled nursing facilities network development, remote patient monitoring expansion, chronic condition pathway implementation, and annual wellness visit completion rate enhancement.
New York Medical Partners ACO (New York City). New York Medical Partners ACO, managed by the Mount Sinai Health System, is designed to meet quality and cost goals for the management of about 50,000 Medicare beneficiaries in the Medicare Shared Savings Program. Through participation in the ACO, Mount Sinai Health System has integrated innovative programs, pooled resources, and developed new methods for streamlining care across a range of services, including chronic disease management, specialty care, complex procedures, and prevention and wellness programs. It has also achieved more than $28 million in savings according to data released in 2021.
Northeast Medical Group ACO (Stratford, Conn.). Northeast Medical Group ACO is Yale New Haven Health’s nonprofit multispecialty medical foundation. Established in 2010, the ACO serves more than 25,000 lives and focuses on providing compassionate, comprehensive primary, specialty, inpatient, outpatient, rehabilitative and preventative care. Since 2018, the ACO has scored among the highest in the northeast region for quality. The organization allows patients to access a provider network of almost 1,500 clinicians across five affiliated hospitals and over 130 community practices. In 2023, Northeast Medical Group managed more than 3.9 million patient encounters. Looking ahead, the ACO is investing in a unified ambulatory risk adjustment operational program, focusing on annual wellness visits and improving metric quality scores.
OSF HealthCare ACO (Peoria, Ill.). Launched in 2012, OSF HealthCare ACO was one of the nation’s first ACOs. It then transitioned to one of the original 18 Next Generation ACOs. Since 2017, OSF has participated in the Medicare Shared Savings Program. During 2020 and 2021, OSF saved CMS over $52 million. The OSF HealthCare accountable care set goals for 2023 that included initiating a region-specific, targeted outreach campaign for beneficiaries of the MSSP, continuation of care management for high-risk beneficiaries, and leveraging technology to assist with a scalable expansion to a systemwide, integrated approach to social drivers of health.
Ochsner Accountable Care Network (New Orleans). Ochsner Accountable Care Network has achieved its seventh consecutive year of top-ranking results in both clinical performance and healthcare savings for the Medicare population in its care. In 2022, the ACO’s participating physicians and providers lowered expected cost of care by more than $27 million for more than 52,000 Medicare beneficiaries. Recent ACO accomplishments include increasing annual wellness visits by 10%, increasing primary care services by 27.7% and reducing unplanned admission by 10% since 2021.
Optimus Healthcare Partners (Summit, N.J.). Optimus Healthcare was one of the first ACOs established from the inception of the Medicare Shared Savings Program. The program takes a holistic approach that prioritizes the patient at every step of the healthcare system. It has saved more than $10 million by achieving high quality and cost savings targets in ACO contracts. Optimus also developed a cloud-based, analytic reporting platform that allowed for the aggregation of patient data sources, data master capabilities and the ability to better care for the patients it serves. The ACO is led by Scott Maron, MD.
Orlando Health Network (Winter Park, Fla.). The Orlando Health Network was created in 2013 and has since generated $165 million in savings to patients, payers, employers and taxpayers. In 2023, the ACO implemented several initiatives to ensure that its almost 300,000 patients receive timely, efficient and effective medical care from over 5,500 providers. Their most impressive accomplishments include the development of customized care pathways for chronic care management, bundled payment programs, refinement of post-acute care networks, the establishment of the new Orlando Health support team for aftercare and resources outpatient centers, the expansion of direct-to-employer models, and the formation of a provider-led network performance committee. For the future, the ACO aims to reduce all-cause 30-day hospitals readmissions, improve its physician support services, increase efforts to reconcile medications and promote medication adherence, and much more.
Palm Beach ACO (Palm Springs, Fla.). Palm Beach ACO strives to improve patient experience and population health while decreasing per capita healthcare costs. The organization features more than 275 PCPs and 175 specialist physician members. It also serves more than 79,000 Medicare beneficiaries. The ACO has been successfully treating patients for over six years.
Physician Partners of Western Pennsylvania (Pittsburgh). Physician Partners of Western Pennsylvania became an ACO in 2017, sponsored by the Centers for Medicare and Medicaid Services. The organization is a Track 1 ACO, offering patients the right care at the right time in the most accurate manner possible. Physicians at the ACO hold 75% of voting board positions on the board of managers, lead board committees, drive decision making and more. The organization aims to engender clinical excellence, partnership, transparency and innovation amongst physicians and hospital systems.
Privia Quality Network (Arlington, Va.). Privia Quality Network is a physician-led ACO aimed at making healthcare delivery more efficient via a multifaceted approach that touches upon quality, coordination and affordability. The ACO boasts over 1.2 million attributed lives, a 93% average quality score, $937 million-plus in total generated savings and 360,000 Medicare beneficiaries. Privia Health delivered more than $131.7 million in shared savings through the 2022 MSSP.
The Queen’s Health System Medicare Shared Savings Program ACO (Honolulu). Queen’s entered the Medicare Shared Savings Program with its ACO in 2017. Led by Whitney Limm, MD, the ACO is looking to enhance quality, coordinate care and lower costs. In 2021, the organization earned a 98% score for exceptional performance. The network covers nearly 16,000 Medicare beneficiaries and realized more than $5 million in cost reductions. The ACO also earned a savings bonus of more than $2 million, which was shared between the health system and its participating providers.
Rainier Health Network, Franciscan Northwest Physicians Health Network (Tacoma, Wash.). Rainier Health Network is an ACO with the goal of delivering high-quality healthcare and driving down costs with an innovative approach to care. The network, first formed in January 2013, is transforming healthcare delivery via physician-led and patient-centric care. The network includes over 7,000 healthcare providers in the area.
Signify Health Collaborative ACO (Dallas). Signify Health, which acquired Caravan Health in 2022, connects hospitals and physicians to deliver more efficient care by leveraging data-driven insights and processes. The organization has helped more than 300 health systems and 26,000 clinicians glean solid results from value-based care. The organization boasts 700,000 attributed Medicare lives, $510 million total savings to Medicare, and 100% of collaborative participants earning shared savings.
Southwestern Health Resources (Farmers Branch, Texas). Southwestern Health Resources is the clinically integrated network formed between Southwestern Medical Center and Texas Health Resources. In 2023, the ACO was one of three in the country to earn the “Leaders in Quality Excellence” award from the National Association of Accountable Care Organizations in recognition of its efforts to improve care quality, patient safety and population health. The ACO was selected in part thanks to its ability to accurately identify patients most likely to incur a preventable event and intervene using a comprehensive care management program. Thanks to this, only 8% of identified patients had an unplanned hospital admission, compared to 34% who did not engage in care management. Earlier this year, Southwestern Health Resources was named among the highest performing ACO Medicare REACH programs in the country. The ACO also realized just over $55.2 million in gross savings to the Medicare Trust Fund. This year, the ACO plans to reduce 30-day all-cause readmissions by 3% and reduce unplanned admissions for patients with multiple chronic conditions by 3%.
Steward National Care Network (Westwood, Mass.). The Steward National Care Network, a subsidiary of Steward Health Care, was established in 2008. The organization, which is rooted in community-based care and value-adds, stretches across nine states. The network encourages collaboration to ensure the best possible patient care. In addition, they handle managed care contracts, medical management services, quality improvement programs, data analysis and information services.
Temple Care (Philadelphia). Led by Steven Carson, BSN, RN, Temple Care is a participant in CMS’s ACO REACH, an alternative payment model program. The program transitioned from being a direct contracting entity in 2022. Temple Care collects patients’ demographic and social needs data so that it can implement the most effective care strategies to achieve the best health outcomes for beneficiaries. Some of Temple Care’s primary goals are to advance the health equity plan, support programmatic outcomes, expand community outreach programs and enhance quality programming for the sub-acute network.
University Hospitals Coordinated Care Organization (Cleveland). Within the past two years, University Hospitals Coordinated Care Organization set a goal to improve patient experience by increasing patient satisfaction scores. The organization implemented a power business intelligence dashboard by mapping survey data to provider data, allowing it to identify trends that could be shared with providers and practices. Thus, the organization was able to show improvement across all measures from baseline data by the end of their first quarter. University Hospitals Coordinated Care Organization is continuing to focus on lowering hospitalizations, decreasing emergency department usage, and shortening lengths of stay. From 2019 to 2023, the ACO improved its outcome data for its attributed Medicare population for diabetes uncontrolled and hypertension controlled metrics. For the coming year, the ACO wants to optimize its provider network and clinical models of care to increase performance on all of its payer contracts.
USMM Accountable Care Partners (Troy, Mich.). USMM Accountable Care Partners provides a wide array of services for over 30,000 patients across 11 states. The network comprises home-based primary care providers that bring top-tier care to the elderly across the nation, with an average patient age of 79 years. USMM earned a $27.9 million payment as part of the Medicare Shared Savings Program for the 2021 reporting period.
Vytalize Health (Hoboken, N.J.). Vytalize Health was named a top performer in the 2022 REACH program. Vytalize partner providers achieved an average savings of $1,343 per beneficiary. Over the past two years, Vytalize Health has grown significantly, topping the Inc. 5000 list of fastest-growing companies in America for 2024. To date, the organization has raised more than $200 million in funding and now effectively manages $4 billion in healthcare services. Most recently, Vytalize Health announced it added key leaders to support continued excellence in value-based care, including a new CIO, CFO and senior vice president of clinical performance. Following a period of rapid growth, the ACO is refining operations with a sharp focus on efficiency.
WellSense Boston Children’s ACO. WellSense Boston Children’s ACO is a partnership between WellSense Health Plan and Boston Children’s Health Accountable Care Organization participating in the MassHealth ACO program. WellSense Boston Children’s ACO provides high-quality healthcare for approximately 130,000 pediatric and young adult Medicaid members who are receiving primary care at Boston Children’s Hospital or at the pediatric physician’s organization at Children’s. The participation of Boston Children’s Hospital and its affiliated specialists and primary care physicians, both in the hospital and in the community, in the MassHealth ACO Program is an important part of the partnership’s shared commitment to providing the best care possible to all the children in the Commonwealth. WellSense Boston Children’s ACO focuses on the cost and quality of all medical and behavioral health services for the members, and includes efforts such as an integrated behavioral health program in primary care, care coordination for children with asthma and medical complexity, and support for children and families with health-related social needs.
WellSpan Health’s Medicare ACO (York, Pa.). WellSpan Health’s Medicare ACO is dedicated to shifting towards value-based care, focusing on payment for outcomes over volume. Serving 67,205 members, the ACO ranks in the top 20% for quality and top 10% for savings. In addition, the WellSpan/Capital Blue Cross Medicare Advantage collaboration has expanded to include 9,700 members and four co-branded health plan products. The ACO also saw meaningful reductions in admissions for patients with various multiple chronic conditions. In 2022, the ACO’s performance saved patients and the Medicare program $21.9 million. The program is one of 16 ACOS in the history of the MSSP program to distribute 100% of earned shared savings to ACO participants in all performance years, cumulatively giving more than $16 million to ACO participants thus far. The ACO has plans to double this in the 2023 and 2024 performance years.
