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welcome everyone today were talking about ACO participation agreements and getting ready for that first phase of forming your Medicare ACO and your network ACO Readiness I just a quick flow chart here um we really see finalizing your participation agreements as a key factor um starting now so that you can have those agreements ready signed and ready to submit next maybe obtaining your Medicare claims needed to review those participants their performance metrics you can get that data today from Medicare without being an ACO so you do have that option um next finalizing your shared savings distribution model and other narratives that might be required or optional so that you know what that distribution model is and you can communicate that to your participants and then doing your OutdocHub obtaining those signatures to the participation agreements submitting them to the CMS portal and getting your ACO approved today I have with me Greg Shockey an ACO expert whos worked in Medicare ACO