It’s largely a continuation of what you are already doing today. We look for performance on the following key measures:

• Annual Wellness Visits (AWVs) — target 70% completion
• Depression screening
• Fall risk assessments
• A1C monitoring for diabetic patients
• Blood pressure management
• Post-discharge follow-up within 5 business days of hospital discharge

You will continue to use the standard Medicare fee schedule for your fee-for-service patients. Additionally, the ACO offers incentive payments, which include (but are not limited to):

• Additional payments for each completed Annual Wellness Visit (AWV)
• Additional payments for timely post-discharge follow-up

This Shared Savings Program applies only to the traditional Medicare fee-for-service population. It excludes patients enrolled in Medicare Advantage or HMO plans.

Claims should continue to be submitted directly to CMS using your current submission process. No additional steps are required for ACO participation.

No, your billing process will not change. You will continue to submit claims to CMS exactly as you do today and receive payment directly from CMS for your fee-for-service patients, including those attributed to the ACO. Any shared savings distributions or incentive payments from the ACO will be handled separately and will not affect your normal claim payments. This is not a capitated model — you remain under the traditional Medicare fee-for-service structure.

Eligible practices can receive up to four quarterly payments during Performance Year 2026 to help support onboarding and quality initiatives. Payments are funded by Medicare Platform, LLC. They are not loans and do not require repayment unless the terms of the Participation Agreement are breached. To qualify, the Participating Provider Agreement must be executed by September 6, 2025.

The check represents a partial advance investment and can only be deposited after:

• Your Participating Provider Agreement is fully executed
• A W-9 is submitted

While results vary by practice, providers in our network have historically earned:

• Increased per-patient revenue through shared savings and quality incentives
• Additional practice-level payments such as advance investments and bonuses for Annual Wellness Visits and timely follow-up
• Greater access to centralized reporting and data insights to improve quality performance and avoid penalties

No. Participation in the ACO only applies to your Original Medicare fee-for-service patients. Your existing commercial, Medicare Advantage, and Medicaid contracts remain unchanged.

We establish a Business Associate Agreement (BAA) with your practice. Under this agreement:

• You share data with the ACO.
• The ACO shares data back with you.

The Medicare Shared Savings Program (MSSP) is already a value-based model. Participation does not move you into a capitated or full-risk model — you remain under the traditional fee-for-service structure.

ACO-level impact: CMS shared savings depend on the ACO meeting its quality standards.
Practice-level impact: If your practice doesn’t meet quality measures, you may receive a reduced portion of shared savings.
No downside risk: This is a one-sided model — if standards aren’t met, the worst outcome is $0 from CMS. We focus on partnering with practices that historically meet or exceed quality standards to maximize success.