Track 1+


NAACOS has strongly supported and been instrumental in developing the Track 1+ ACO model, and 2018 is the first performance year for the model. Track 1+ creates a glide path for ACOs to take on risk and includes lower risk levels than those required in other Medicare ACO models. Track 1+ includes elements of Medicare Shared Savings Program Track 1 and Track 3.


  • CMS Track 1+ Factsheet
  • CMS’s MSSP ACO Track 1+ Model, and SNF 3-Day Rule Waiver 2018 Application Reference Manual
  • NAACOS ACO Comparison Chart details elements of Track 1+ and other MSSP tracks and the Next Generation ACO model

News and Advocacy


  • The application deadline for July 1, 2019 starts is February 19



  • CMS released guidance on apply for the new waiver from the Skilled Nursing Facility (SNF) 3-Day Rule

  • CMS releases final ACO ‘Pathways to Success’ rule on 12/21/18

  • NAACOS holds webinar providing in-depth review of final ‘Pathways to Success’ rule and participation options for 2019 and beyond 

  • Notice of Intent to Apply for July 1, 2019 start in new ‘Pathways to Success’ structure of the MSSP due January 18, 2019

  • 2019 MSSP application details provided on the CMS website

  • NAACOS statement on the final Pathways to Success rule

  • NAACOS analysis of the final 2019 Physician Fee Schedule and Quality Payment Program rule

  • NAACOS Review of ACO Pathways to Success Provisions included in the Medicare Physician Fee Schedule Rule 

  • 2019 Application Considerations for ACOs

  • NAACOS resource provides highlights of the 2018 Medicare ACO class and shows ACO growth over time

  • CMS announces 561 MSSP ACOs in 2018, including 55 Track 1+ ACOs
  • NAACOS’s paperDifferences Between Medicare ACO Tracks that May Impact ACO Financial Results
    • NAACOS interactive table for ACOs to input their own projected values to help ACOs illustrate how they may perform under the various tracks. 

  • NAACOS letter urges CMS to lessen repayment mechanism requirements for revenue-based Track 1+ ACOs
    • CMS responds to NAACOS request by modifying the Track 1+ repayment mechanism requirements

  • CMS updated Track 1+ program information and FAQs in this factsheet and hosts webinar on Track 1+

  • NAACOS provides detailed comments to CMS on implementation of Track 1+ and other key ACO improvements
  • As part of the Episode Payment Model final rule published in early 2017, CMS provides information on Track 1+ which is explained in this NAACOS Overview 

  • NAACOS and others submit comments to CMS on developing Track 1+
    • NAACOS and Premier press release on comments to CMS on developing Track 1+