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 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 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

To learn more about the number and geographic locations 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 4/10/19) (PDF)

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

  • 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.

For the July 1, 2019, start date, and future start dates, Track 1, Track 2, the deferred renewal option (for ACOs that participated under Track 1 for an initial agreement period), and the Medicare ACO Track 1+ Model (Track 1+ Model)* will no longer be available as participation options. ACOs currently participating in a three-year agreement period (with a start date of January 1, 2019 and earlier) under Track 1, Track 2, Track 3, and the Track 1+ Model may complete the remainder of these agreement periods.

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

*The Track 1+ Model is a time-limited CMS Innovation Center model. An ACO must concurrently participate in Track 1 of the Shared Savings Program in order to be eligible to participate in the Track 1+ Model.


Frequently Asked Questions

CMS has made 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:
11/13/2019 03:30 PM