Track 1+


NAACOS has strongly supported and been instrumental in developing the Track 1+ ACO model, and 2018 was 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 in the Pathways to Success regulation retired Track 1+, which is becoming Basic Level E under the program’s new structure. NAACOS provides more information on Pathways on this page and additional resources on the MSSP here.

As a result of the COVID-19 pandemic, CMS announced it would extend by a year Track 1+ for ACOs with agreements ending on December 31, 2020. More information on actions taken by CMS in light of COVID-19 can be found on this page.


News and Advocacy


  • CMS announces a voluntary 1-year agreement extension for ACOs with agreement periods ending on December 31, 2020, including Track 1+ Model ACOs 

  • CMS Releases 2020 MSSP Report Schedule


  • 2018 performance data from CMS shows MSSP generated $1.7 billion in savings, prompting this NAACOS statement
    • NAACOS resource includes highlights from the 2018 MSSP results

  • NAACOS chart of CMS Innovation Center models and their overlap with ACOs

  • Key deadlines and action dates for 2020 applicants issued by CMS

  • NAACOS calls on CMS to extend July 1, 2019 application period


  • CMS releases final ACO ‘Pathways to Success’ rule

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

  • 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 

  • 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

  • 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+