For Accountable Care Organizations (ACOs)
Guidance for Accountable Care Organizations (ACOs) applying to and participating in the Shared Savings Program, including an overview of the agreement period, as well as application resources.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 21, 2020
This page contains information for Accountable Care Organizations (ACOs) applying to and participating in the Medicare Shared Savings Program (Shared Savings Program), including information about the Application Types & Timeline and Application Guidance & Toolkit webpages.
Application submission activities and certain program operations are conducted in the ACO Management System (ACO-MS).
Program Participation
For more information and resources on the program methodologies and participation requirements, refer to the Program Guidance & Specifications webpage.
Information for Applicants
All ACO applicants should reference the following resources.
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Application Types & TimelineFind sample applications and related resources. | Application Guidance & ToolkitFind the Application Reference Manual and guidance to help ACOs apply to the Shared Savings Program. |
For application questions, visit the Contact Information webpage.
Application Guidance
The Application Toolkit provides quick access to guidance relevant to all application types. For more information about applying to the Shared Savings Program, refer to the Application Guidance & Toolkit webpage.
ACO Participant List and Participant Agreement Guidance
Participating ACOs may modify their ACO Participant List and associated agreements for the upcoming performance year during established timeframes. For additional information, refer to the Application Guidance & Toolkit webpage.
SNF 3-Day Rule Waiver Guidance
Participating ACOs approved for a Skilled Nursing Facility (SNF) 3-Day Rule Waiver may modify their SNF Affiliate List and associated agreements for the upcoming performance year during established timeframes.
For additional information on the SNF 3-Day Rule Waiver, refer to the Application Guidance & Toolkit webpage.
Yearly ACO Signing Event
On an annual basis, the Shared Savings Program requires ACOs to review, certify, and electronically sign official program documents. Prior to the start of the upcoming performance year, ACOs must complete the Yearly ACO Signing Event. For additional information, refer to the Application & Guidance Toolkit webpage.
Primary Service Area Calculation
CMS makes data available to applicants to allow them to calculate their share of services in each applicable primary service area as described by the Antitrust Enforcement Policy.
Requesting Technical Assistance and Reconsideration Review Guidance
ACOs may request an appeal of an initial determination by CMS in limited circumstances.
HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.