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).
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.
Application Types & Timeline
Find sample applications and related resources.
Application Guidance & Toolkit
Find the Application Reference Manual and guidance to help ACOs apply to the Shared Savings Program.
For application questions, visit the Contact Information webpage.
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.
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.
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.