Launching a new MSSP ACO requires careful early planning across performance, compliance, and quality reporting. This eBook provides a practical overview of the key considerations new ACOs face as they move from application into their first performance year under the Medicare Shared Savings Program. Drawing on experience supporting emerging ACOs, it outlines foundational decisions related to governance, data readiness, compliance activities, and reporting approaches that help organizations establish a stable and effective PY1 foundation.

Designed for ACO leaders, this roadmap breaks down what’s changing in PY26 and what matters most for new, mid-agreement, and final-year organizations. It highlights early actions and strategic considerations to support performance, risk management, and informed decision-making across the years