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 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.


News and Advocacy



  • 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+