CMS has announced the Long-term Enhanced ACO Design (LEAD) Model, the Innovation Center’s next Accountable Care Organization (ACO) initiative. LEAD is designed to bring more providers into the ACO framework, including those who have historically faced barriers to participation, such as smaller, independent, or rural-based practices. The model also emphasizes care for patients with high needs, including dual eligibles and individuals who are homebound or home-limited.
LEAD incorporates an improved benchmarking methodology and other design features to support providers serving patients with complex needs while addressing financial and administrative challenges that have previously limited participation in ACOs. The model is structured as a 10-year program starting January 1, 2027, with applications opening in March 2026.
This initiative reflects the Innovation Center’s broader goals of rewarding providers for delivering higher-quality care, promoting patient choice in coverage and care settings, and encouraging preventative care that supports healthier outcomes. LEAD represents a significant step toward making ACO participation more accessible while advancing value-based care across diverse populations.
Resources: LEAD Model Webpage
CMS Innovation Center Strategic Direction
Value-Based Care Spotlight
Innovation Insights