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Table 1

Types of Medicare ACO Programs

ACO program	Years implemented	Target organizations	Level of risk sharing	Number of participants in first year	Current participants
Medicare Shared Savings Program	2012–Ongoing	All organizations	Multiple options with different levels of upside and downside risk	220	483
Next-generation ACO model	2016–2021	ACOs open to much stronger financial risk (80%–100% of savings/losses)	Upside and downside	18	41
ACO investment model	2015–2018	ACOS in rural or low-penetration areas	Upside and downside	41	N/A
Pioneer ACO model	2012–2016	Organizations with experience in earlier ACO-like arrangements willing to take on higher financial risk	Multiple options with different levels of upside and downside risk	32	N/A
ACO advance payment model	2012–2014	Small physician-based organizations	Upside	20	N/A

ACO program	Years implemented	Target organizations	Level of risk sharing	Number of participants in first year	Current participants
Medicare Shared Savings Program	2012–Ongoing	All organizations	Multiple options with different levels of upside and downside risk	220	483
Next-generation ACO model	2016–2021	ACOs open to much stronger financial risk (80%–100% of savings/losses)	Upside and downside	18	41
ACO investment model	2015–2018	ACOS in rural or low-penetration areas	Upside and downside	41	N/A
Pioneer ACO model	2012–2016	Organizations with experience in earlier ACO-like arrangements willing to take on higher financial risk	Multiple options with different levels of upside and downside risk	32	N/A
ACO advance payment model	2012–2014	Small physician-based organizations	Upside	20	N/A

Note: ACO = accountable care organization.