Phase 1 Submission

May 20, 2024 - June 17, 2024 at 12:00 p.m. (noon) ET

Accountable Care Organizations (ACOs) will complete:

• ACO Management System (ACO-MS) registration

ACOs will submit:

• ACO Participant List (including executed ACO Participant Agreements)
• Form CMS-588 Electronic Funds Transfer (EFT) Authorization Agreement Package
• Skilled Nursing Facility (SNF) 3-Day Rule Waiver application*
• SNF Affiliate List (including executed SNF Affiliate Agreements)*
• Repayment mechanism (RM) documentation*

ACOs will select:

• Track and/or level
• Minimum savings rate/minimum loss rate*
• Beneficiary assignment methodology

ACOs will receive:

• Immediate beneficiary assignment estimates for each ACO Participant Tax Identification Number (TIN) at submission

Phase 1 RFI-1

July 11, 2024 – August 1, 2024 at 12:00 p.m. (noon) ET

Available actions:

• Review Participation Options Report in ACO-MS
• Submit Form CMS-588 EFT Authorization Agreement Package
• Complete SNF 3-Day Rule Waiver Application*
• Submit RM documentation*
• Correct any deficiencies identified by the Centers for Medicare & Medicaid Services (CMS) and/or modify responses submitted within Section 2 of your Phase 1 application task

Final Opportunity to:

• Add ACO participant and/or SNF affiliate TINs
• Elect to apply for a SNF 3-Day Rule Waiver*

ACOs receive:

• Immediate beneficiary assignment estimates for each ACO Participant TIN at submission

Your ACO cannot edit responses in Phase 1 Section 1: ACO Information within your Phase 1 application task.

Phase 1 RFI-2

August 22, 2024 –September 5, 2024 at 12:00 p.m. (noon) ET

Available actions:

• Review Participation Options Report in ACO-MS
• Submit Form CMS-588 EFT Authorization Agreement Package

Final opportunity to:

• Upload executed agreements and merger/acquisition documentation and change the merged/acquired indicator on pending change requests
• Withdraw or delete ACO participants 
• Withdraw SNF affiliates
• Complete SNF 3-Day Rule Waiver application*
• Correct any deficiencies identified by CMS and/or modify response submitted within Section 2 of your Phase 1 application task
• Submit RM documentation*

Your ACO cannot add/edit any ACO participant or SNF affiliate TINs, or edit information in Phase 1 Section 1 of the application

Phase 1 Dispositions

October 17, 2024

CMS makes available:

• ACO Participant List and SNF Affiliate List Dispositions
• Beneficiary Assignment Eligibility Phase 1
• Advance Investment Payments (AIP) Eligibility Final Disposition

Phase 2 Submission

October 18, 2024 – October 29, 2024 at 12:00 p.m. (noon) ET

ACOs will submit:

• ACO's governing body and organizational chart
• Governing body narrative*
• AIP supplemental information, inclusive of spend plan*
• Beneficiary Incentive Program (BIP) application*

Your ACO cannot modify any information submitted within the Phase 1 application task, including the ACO Participant List and SNF Affiliate List

Phase 2 RFI

November 8, 2024 – November 18, 2024 at 12:00 p.m. (noon) ET

Final opportunity to:

• Correct any deficiencies on Phase 2 elements identified by CMS
• Modify any response submitted within Phase 2 of your application task

Your ACO cannot modify any information submitted within the Phase 1 application task, including the ACO Participant List and SNF Affiliate List

Final Application Dispositions

December 5, 2024

CMS makes available:

• Application disposition
• SNF 3-Day Rule Waiver disposition*
• BIP disposition*
• AIP disposition*

ACO Signing Event

December 6, 2024 – December 12, 2024 at 12:00 p.m. (noon) ET

ACOs must:

• Review, certify, and electronically sign documents related to your participation in the Medicare Shared Savings Program (Shared Savings Program)
• Confirm your organization’s information (e.g., ACO legal entity name (LEN), ACO TIN, ACO business address) and contact information

Initial Application (PDF)

AIP Supplemental Information (PDF)

• An ACO that is applying to participate in the Shared Savings Program that is not considered to have previously participated in the Shared Savings Program.
• An ACO that either previously participated in the Shared Savings Program and is applying to participate in the Shared Savings Program after a break in participation or that CMS determines to be re-entering because greater than 50 percent of their ACO participants have prior participation in the same Shared Savings Program ACO in any of the five most recent past performance years (re-entering ACO).

Advance Investment Payments (AIP) 

• The Shared Savings Program offers a payment option, AIP, to provide an opportunity for entities in rural and underserved areas 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.
• An ACO that is interested in receiving advance investment payments will need to complete supplemental informational materials as part of their initial application. (Only available to ACOs in the Level A who are low revenue.)

• An ACO currently participating in the Shared Savings Program that is in the final performance year of its most recent ACO Participation Agreement and intends to renew its participation for a new agreement period starting on January 1^st of the upcoming calendar year without a break in participation.
• An ACO currently participating in the Shared Savings Program that elects to voluntarily terminate its ACO Participation Agreement with an effective date of termination of December 31^st of the current performance year and intends to apply for a new agreement period starting on January 1^st of the upcoming calendar year without a break in participation.

SNF 3-Day Rule Waiver Application (PDF)

• An ACO applying for approval of a SNF 3-Day Rule Waiver. Available for ACOs applying to or currently participating in the Shared Savings Program under Levels C, D, or E of the BASIC track, or the ENHANCED track.

•  An ACO applying to establish and operate a BIP. Available for ACOs applying to or currently participating in the Shared Savings Program under Levels C, D, or E of the BASIC track, or the ENHANCED track.