The Accountable Care Organization (ACO) Investment Model (AIM) is a model from the Innovation Center at the Centers for Medicare & Medicaid Services (CMS). Through AIM, CMS makes up-front payments to ACOs participating in the Medicare Shared Savings Program. The payments are invested in infrastructure and staffing and then recouped from earned savings, which are shared between the ACO and CMS. The goals of the model are to reduce expenditures and preserve or enhance the quality of care, to promote the formation of new ACOs in rural or underserved areas, and to encourage smaller existing ACOs to transition to new models in which they take on greater financial risk. 

This first evaluation report shares results from the first performance year of AIM ACOs, including participation patterns, management company involvement, and the extent of recoupment of AIM payments. A first cohort of four AIM ACOs started in April 2015, and a second cohort of 43 AIM ACOs started in January 2016.

In their first performance year, AIM ACOs seemed to show that ACOs under upside-only financial risk in rural areas can, with up-front funding and management company support, lower Medicare spending with no sign of reductions in quality of care.

Download the At-a-Glance Findings to learn more.
Download the ACO AIM report appendices.