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Specifically, under proposed new 425.308(b)(10), we are proposing that, for each performance year, an ACO would be required to report (in a standardized format specified by CMS) its spend plan for each performance year, the total amount of prepaid shared savings received, and an itemization of how any prepaid shared savings were actually spent during each year, including expenditure categories, the dollar amounts spent on the various categories, information about which beneficiaries received direct beneficiary services that were purchased with prepaid shared savings and investments that were made in the ACO with prepaid shared savings, any changes to the spend plan as submitted under 425.640(d)(1), and such other information as may be specified by CMS

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