CMS Invites ACOs to Apply to the New LEAD Model
What’s new: Today, CMS released the Request for Applications (RFA) for the Long-term Enhanced ACO Design (LEAD) Model, which aims to expand the benefits of Accountable Care Organizations (ACOs) to more Medicare beneficiaries; the model supports a broad range of participants and providers by offering enhanced support to small, independent, and rural practices delivering primary care, as well as those serving high-needs beneficiaries, and introduces new flexibilities and opportunities for specialist integration and health promotion.
Why it matters: LEAD builds on the CMS Innovation Center’s accountable care work and addresses long-standing barriers to ACO participation through improved benchmarking that supports both new and established ACOs, enhanced population-based payments, and new flexibilities to support healthy living and preventive care.
What to expect: ACOs interested in the voluntary, 10-year model have until May 17, 2026, to respond to the RFA; the model will launch Jan.1, 2027.
The big picture: By appealing to a broader range of health care providers, LEAD will help more people—including those with complex health needs—benefit from better coordinated, accountable care; ACOs have been shown to improve access to preventive screenings and chronic disease management while reducing the need for emergency care, all of which support healthier lives and more affordable health care.
Additional details: Participating providers can expect enhanced, more stable payments, along with greater flexibility and tools to help them spend more time with patients to better meet their individualized, often complex needs.
Key design features of LEAD include:
- Integration of high-needs patients across all ACOs
- Two voluntary risk-sharing options: Global (100%) and Professional (50%)
- Flexibilities to support healthy living
- Medicaid integration for dually eligible beneficiaries
- CMS-administered risk arrangements (CARA)
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