About the Program

The Shared Savings Program is committed to achieving better health for individuals, better population health, and lowering growth in expenditures.

Shared Savings Program

The Medicare Shared Savings Program (Shared Savings Program) offers providers and suppliers (e.g., physicians, hospitals, and others involved in patient care) an opportunity to create an Accountable Care Organization (ACO). An ACO agrees to be held accountable for the quality, cost, and experience of care of an assigned Medicare fee-for-service (FFS) beneficiary population. The Shared Savings Program has different tracks that allow ACOs to select an arrangement that makes the most sense for their organization.

The Shared Savings Program is an important innovation for moving the Centers for Medicare & Medicaid Services' (CMS') payment system away from volume and toward value and outcomes. It is an alternative payment model that:

  • Promotes accountability for a patient population.
  • Coordinates items and services for Medicare FFS beneficiaries.
  • Encourages investment in high quality and efficient services.

Accountable Care Organizations

The Shared Savings Program is a voluntary program that encourages groups of doctors, hospitals, and other health care providers to come together as an ACO to give coordinated, high quality care to their Medicare beneficiaries.

To learn more about ACOs, visit the Accountable Care Organizations webpage.

For providers interested in learning more about participation in Shared Savings Program ACOs, visit the For Providers webpage.

National Participation 

Map of United States showing 477 Shared Savings Program ACOs are providing care to 10.7 million beneficiaries in Performance Year 2021.

To learn more about the number and geographic location of Shared Savings Program ACOs, reference Program Data.

Shared Savings Program ACO Participation Options

The Shared Savings Program offers different participation options (tracks) that allow ACOs to assume various levels of risk. The following table summarizes participation options under the BASIC track and ENHANCED track for agreement periods of at least five years, beginning on July 1, 2019, and in subsequent years.

Shared Savings Program ACO Participation Options (Updated 4/30/2021) (PDF)

CMS uses a combination of factors to determine an ACO’s participation options, including the following:

  • Past experience of the ACO and its ACO participants in performance-based risk Medicare ACO initiatives, and
  • Whether the ACO is a low revenue ACO or high revenue ACO.

Eligible ACOs may apply for a Skilled Nursing Facility (SNF) 3-Day Rule Waiver, and/or to establish and operate a Beneficiary Incentive Program (BIP) and use expanded telehealth services.

Frequently Asked Questions

CMS makes available frequently asked questions (FAQs) to reference for more information about the program. To read these FAQs, refer to the Medicare FFS FAQs.

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Page Last Modified:
12/01/2021 08:00 PM