The Affordable Care Act seeks to improve the quality of health care services and to lower health care costs by encouraging providers to create integrated health care delivery systems. The integrated systems will test new reimbursement methods intended to create incentives for health care providers to enhance health care quality and lower costs. The Medicare Shared savings program under section 3022 of the Affordable Care Act, which promotes the formation and operation of Accountable Care Organizations (ACOs) is one important delivery system reform where groups or providers meeting the criteria specified by the Secretary may work together to manage and coordinate care for Medicare beneficiaries through an ACO. In addition, section 3021 of the Affordable Care Act establishes a Center for Medicare and Medicaid Innovation (CMMI) within CMS, which is authorized to test innovative payment and service delivery models. As we develop our initial rulemaking for the Shared Savings Program and begin the development of potential models in CMMI, we are seeking request for comments regarding certain aspects of the policies and standards that will apply to ACOs participating in the Medicare program under section 3021 or 3022 of the Affordable Care Act. To be assured consideration, comments must be received no later than December 3, 2010.