Learn about the application process to join, continue, or renew participation in the Shared Savings Program.
Application TimelineThe Application Reference Manual is the primary resource for ACOs applying to the Shared Savings Program and guides ACOs through the application process.
In addition to the Application Reference Manual, the resources below will assist ACOs with submitting the different elements of their application(s) and responding to requests for information (RFIs) in ACO-MS.
The Managing Program Participation Guidance is the primary resource for ACOs currently participating in the Shared Savings Program. This document guides current ACOs in managing and maintaining program participation for your ACOs current agreement period. For more information, please refer to the Key Change Request Actions and Deadlines found in the Knowledge Library.
Guidance
An ACO Participant is an entity identified by a Medicare-enrolled TIN through which one or more ACO providers/suppliers bill Medicare. The document describes the requirements that an ACO participating in or applying to the Shared Savings Program must follow with respect to its ACO Participant List, ACO Provider/Supplier List, and ACO Participant Agreement. Currently Participating ACOs may modify their ACO Participant List and associated agreements for the upcoming performance year during established timeframes.
ACO-MS Resources
Other Resources
In order to receive payments from CMS, ACOs must submit Form CMS-588, the accompanying Form CMS-588 cover sheet, and the required supporting financial documentation as part of the application.
The new advance investment payments will enable health care providers in rural and other underserved areas to build the staffing, infrastructure, and care delivery improvements they need to succeed as ACOs providing high quality, equitable, accountable care to their communities.
Meena Seshamani, M.D., PhD, Deputy Administrator and Director of the Center for Medicare
The Shared Savings Program offers a payment option, AIP, to provide an opportunity for entities to join together to form ACOs, build the infrastructure needed to succeed in the Shared Savings Program, and promote equity by holistically addressing beneficiary needs, including social needs.
To be eligible for advance investment payments, ACOs must be initial applicants identified as low revenue and inexperienced with performance-based risk and have selected level A of the BASIC track.
An ACO that is interested in receiving advance investment payments will need to complete supplemental informational materials as part of their initial application.
An ACO must demonstrate that it has established an adequate repayment mechanism prior to the start of its agreement period to be eligible to participate in a two-sided risk model of the Shared Savings Program (Levels C, D, or E of the BASIC track, or the ENHANCED track).
The SNF 3-Day Rule Waiver waives the requirement for a 3-day inpatient hospital stay prior to a Medicare-covered, post-hospital, extended-care service for eligible beneficiaries if certain conditions are met. Only Shared Savings Program ACOs that are currently participating in or applying to certain Shared Savings Program performance-based risk tracks have the opportunity to apply for a waiver of the SNF 3-Day Rule, and they must apply separately for the waiver during the annual application process..
The ACO Primary Care Flex Model (ACO PC Flex Model) is a voluntary model that will focus on primary care delivery in the Shared Savings Program. It will test how prospective payments and increased funding for primary care in ACOs impact health outcomes, quality, and costs of care. The flexible payment design will empower participating ACOs and their primary care providers to use more innovative, team-based, person-centered and proactive approaches to care.
ACOs who are interested in the ACO PC Flex Model must first apply the Shared Savings Program. ACOs who do not have an application to begin a new agreement period will not be able to respond the ACO PC Flex Model Request for Application.
ACOs participating in certain two-sided models may apply to establish and operate a BIP to provide an incentive payment with a value of up to $20 to each assigned beneficiary for each qualifying primary care service received.
To participate in the Shared Savings Program, each ACO must have a compliance plan, upon request, the ACO must submit the compliance plan to demonstrate that it satisfies the regulation requirements. ACOs must certify that they have completed a compliance plan.
Prior to the start of a new performance year and at the end of each performance year (as applicable), the Shared Savings Program requires all ACOs to review, certify, and electronically sign documents related to their participation in the Shared Savings Program.
ACO-MS is the system used to apply to the Shared Savings Program. Below are tip sheets that support the application process.