There have been many changes to ACO, MIPS, and CPC+ quality measures reporting in the last year have reflected the changes needed to best serve a population in the midst of a pandemic. While the goal for these changes has been to provide a better path towards quality care reporting, they pose a significant burden on ACOs and may misrepresent the quality of care they provide for their patients. Because of this, many of these rule changes may be in flux as NAACOS petitions CMS to delay mandatory quality reporting for the MSSP (Medicare Shared Savings Program).