By Alex Bardakh, VP of Government Affairs and Policy, CareConnectMD
Key takeaways
- LEAD is a new CMS accountable care model that will begin Jan. 1, 2027, replacing ACO REACH.
- LEAD offers several unique features that promise to deliver value, including a 10-year performance period with no rebasing, enhanced support for high-needs-focused practices and facilities, and expanded payment options.
- Although the LEAD Participant addition deadline was on August 5, 2026, participants can still join LEAD in the Hybrid window from December 2026 through January 2027 for an April 1, 2027 participation. CareConnectMD is here to help.
The Centers for Medicare & Medicaid Services (CMS) is actively updating financial incentives to hit its 2030 goal of placing all Traditional Medicare beneficiaries in accountable care organizations—networks of doctors, facilities, and other providers who work together to deliver high-quality, coordinated care to a patient population. One of the most recent examples is the Long-term Enhanced ACO Design (LEAD) Model, a 10-year accountable care initiative that succeeds ACO REACH and is designed to expand participation in value-based care. LEAD represents one of the most significant opportunities in recent years for organizations that have not yet participated in an ACO—and even those who have—to enter accountable care with greater stability, flexibility, and support.
At CareConnectMD, a top-performing high-needs ACO dedicated to serving complex patients, we encourage qualifying organizations to strongly consider joining LEAD. Here are three of the most compelling reasons:
1. LEAD’s 10-year performance period with no rebasing offers long-term financial stability.
Perhaps the most important innovation within LEAD is its 10-year performance period with no benchmark rebasing. For years, groups have been hesitant to participate in accountable care because benchmarks are recalculated at the end of each period. As organizations successfully reduce costs and improve efficiency, their future benchmarks are often reset, creating a moving target that makes it increasingly difficult to sustain shared savings performance.
LEAD takes a fundamentally different approach. CMS establishes a baseline benchmark using three calendar years of historical spending data (CY2024, CY2025, and CY2026), and that baseline remains fixed throughout the model’s entire 10-year performance period. The result is a stable, transparent benchmark structure that rewards investment and long-term improvement. For organizations considering their first entry into accountable care, and for those whose past performance may have been impacted by a moving target, this stability creates a unique opportunity to invest confidently.
2. LEAD significantly enhances support for providers caring for high-needs patients.
At CareConnectMD, we have seen firsthand that effective care for medically complex patients requires resources, coordination, and incentives aligned with patient outcomes. LEAD places high-needs beneficiaries at the center of its design. Rather than creating a separate track, CMS applies high-needs policies across participating ACOs and incorporates benchmarking and risk-adjustment approaches intended to more accurately reflect the realities of caring for complex populations.
The model is also designed to improve care for individuals who are dually eligible for Medicare and Medicaid, homebound, or otherwise medically vulnerable. Enhanced support for these populations can help practices and facilities deliver more comprehensive care while reducing avoidable hospitalizations and emergency department utilization. For organizations serving seniors with multiple chronic conditions, LEAD presents a rare opportunity to align mission and financial sustainability.
3. LEAD can improve cash flow by expanding prospective payment options.
A third compelling reason to consider LEAD is its enhanced approach to funding. One of the most persistent challenges facing ACO participants is the need to invest in care coordination, preventive outreach, analytics, and patient engagement long before the financial benefits of those activities are realized.
LEAD directly addresses this challenge by retaining and expanding population-based payment mechanisms, including partial capitation options that provide participating organizations with more predictable cash flow.
Because LEAD qualifies as an Advanced Alternative Payment Model (Advanced APM), clinicians may receive additional financial and administrative advantages as well, like exemption from traditional MIPS reporting and APM bonuses.
The LEAD window is still open
While the early August participation milestone has passed, CMS will allow new entities to still join LEAD in the Hybrid window from December 2026 through January 2027 for an April 1, 2027 participation. So, the time to act is now; contact CareConnectMD today.
The healthcare system is moving steadily toward accountable care. LEAD offers a rare combination of long-term stability, enhanced support for high-needs populations, and expanded payment options. For organizations that have not yet joined an ACO, the question is no longer whether value-based care will shape the future of Medicare, but whether they will participate in that transformation.
FAQs
What is LEAD?
LEAD is a new CMS accountable care model that will begin Jan. 1, 2027, designed to replace ACO REACH.
Why should physician practices and LTC facilities consider LEAD?
LEAD is a promising option for organizations that have never participated in accountable care, and even for those that have. LEAD offers several unique features that promise to deliver value, including a 10-year performance period with no rebasing, enhanced support for high-needs-focused practices and facilities, and expanded payment options.
Is it too late for new organizations to participate in LEAD?
Although the LEAD Participant addition deadline was August 5, 2026, new entities can still join LEAD in the Hybrid window from December 2026 through January 2027 for an April 1, 2027 participation.
Who should organizations contact if interested in joining LEAD?
CareConnectMD (CCMD) can help. CCMD is a top-performing high-needs ACO with a track record of improving outcomes while reducing costs. CCMD has already built the advanced care model, technology infrastructure, data analytics, and financial models that LEAD requires, and can ease your transition to value-based care. Contact Ellsworth Harris at eharris@careconnectmd.com to learn more.