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National ACO Model & Implementation​

Client Health Holding Company
Region Saudi Arabia
Sector Public Sector, Health and Not For Profit
Testimonial

The Challenge

Saudi Arabia is delivering one of the world’s most ambitious healthcare transformations under Vision2030, transitioning from a centrally run Ministry of Health system to a devolved, accountable care model.​

This shift required:​

  • Separation of accountability across CNHI (payer), Health Holding Company (provider steward), and MoH 2.0 (regulator).​
  • Design and activation of 20 Accountable Care Organizations (ACOs) responsible for ~25 million citizens.​
  • Movement from policy and design into real, system-wide implementation, with healthcare clusters needing to understand, interpret, and operationalise new requirements.​

Our Approach

We partnered with HHC to deliver both the design and implementation of the ACO Manual – combining a rigorous national framework with large-scale capability uplift and readiness.​

  1. Design a clear, implementable national framework: Co-developed the ACO Manual, covering 11domains, 60+ sub-domains, and Gate 1–4 maturity criteria, with clear evidence requirements. Manual wasanchored in best practice from USA, UK and Singapore translated to KSA context.​
  2. Refining the Manual: Applied design-thinking approach combining speed, external insight and nationalcross-entity validation (MoH, HSTP, CNHI, HHC and Clusters) through a series of national workshops anditerative drafts and refinement.​
  3. Embedding the Manual at Scale: Delivered a targeted capability-building programme to support rolloutreadiness, including 41 engagement sessions across all 20 clusters, delivered in partnership with a facultyof 20+ international experts and engaging 600+ participants. This was complemented by two nationalCluster CEO summits, reinforcing leadership ownership and accountability.​

Key Outcomes

  • National Standard Established: A single, nationally endorsed ACO model adopted as the official national standard (Nov 2025), aligning HHC, MoH, CNHI, and all 20 clusters around a common definition and readiness framework.​
  • Unprecedented Scale of Engagement & Mobilization: 41 national engagement sessions delivered, mobilising 600+ leaders across all 20 clusters, creating shared understanding, validating requirements, and accelerating system-wide readiness.​
  • Leadership Alignment Secured: 100% CEO participation achieved across two national CEO summits whilst securing full leadership buy-in and clear executive ownership for Gate 3–4 delivery.​
  • Measured Knowledge Uplift: Measured improvement in cluster understanding of the ACO Manual from 3.4/5 → 4.2/5, evidencing increased clarity, confidence, and readiness to implement.​

What our clients say about us

“I want to extend my gratitude to all the Q5 team on achieving this huge milestone for HHC & the Kingdom, your patience and dedication pays off today with the approval of the manual, a moment to keep and an achievement to be proud of. Thank you”​

Exec. Director – Planning & Oversight, HHC​
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Q5 is a trading name of Q5 Ltd, which is registered in Riyadh, Registration No. 7040626454.
The Registered Office is 6321 Olaya Street, Al Sahafah District, Riyadh 13321, KSA.
Saudi Vision 2030