ACO MSSP Statement of Work FY27 Draft for SSN

Department of Health and Human Services

AF

T

Centers for Medicare & Medicaid Services

R

Statement of Work

D

Accountable Care Organization
Medicare Shared Savings Program®
(ACO MSSP) Financial Services
(draft November 2026)

A. Purpose

The financial services contractor (Contractor) shall be responsible for making payments and providing related financial services in support of the Accountable Care Organization (ACO) Medicare Shared Savings Program (MSSP) for the Centers for Medicare & Medicaid Services (CMS).

B. Background

T

The Medicare Shared Savings Program (MSSP) offers providers and suppliers (e.g., physicians, hospitals, and others involved in patient care) an opportunity to create an Accountable Care Organization (ACO). An ACO agrees to be held accountable for the quality, cost, and experience of care of an assigned Medicare Fee-for-Service (FFS) beneficiary population. The goal is for the ACO to focus on delivering the right care at the right time, while avoiding unnecessary services and medical errors. When the ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, the ACO may be eligible to share in the savings it achieves for Medicare. The MSSP has different participation options (tracks) that allow ACOs to select an arrangement that makes the most sense for their organization.

AF

The MSSP is an important innovation for moving the CMS' payment system away from volume and toward value and outcomes and is an alternative payment model that: •

Promotes accountability for a patient population.

•

Coordinates items and services for Medicare FFS beneficiaries.

•

Encourages investment in high quality and efficient services.

R

Under the MSSP, providers of services and suppliers that participate in an ACO continue to receive traditional Medicare FFS payments under Parts A and B. ACOs that successfully meet quality and savings requirements share a percentage of the savings with Medicare. ACOs under a performancebased risk track may also be required to repay Medicare for shared losses.

D

As of January 1, 2026, there are 511 ACOs participating in the MSSP, serving a total of 12.6 million beneficiaries. Within the MSSP, CMS enters into agreements with ACOs. ACOs facilitate coordination and cooperation among health care providers to improve the quality of care for Medicare FFS beneficiaries and reduce the rate of growth in expenditures under Medicare Parts A and B. For each performance year of the agreement period, ACOs share in a percentage of the savings they generate if