Navigating the Fog: How Health Plans Can Succeed Through Policy and Market Shifts
Healthcare organizations are in a period of accelerated transformation. Evolving Medicare Advantage policies, mounting Medicaid funding pressures, pharmacy closures, and increased regulatory scrutiny are converging to create a more complex and challenging operating environment. At the same time, this disruption is creating significant opportunities for transformation. As financial and operational pressures intensify, organizations are reevaluating […]
The MSSP ACO Application is Approaching: Are You Preparing Accordingly?
The Medicare Shared Savings Program (MSSP) is a progressive risk sharing program created as part of the Affordable Care Act in 2010 that enables physician networks to take risk against a budget and share in potential savings. Within the program, physicians create Accountable Care Organizations (ACOs) to cover a Medicare Fee for Service (FFS) population […]
LEAD Readiness Room Recap: Your Top Questions Answered
In our recent LEAD Readiness Room webinar, industry leaders and current ACO REACH participants shared insights, lessons learned, and key questions around the opportunities and uncertainties within LEAD. Here are the key themes from the discussion, framed through the questions top of mind for attendees. What do you find most exciting about the new model? […]
Inside the LEAD Model Benchmarking Methodology
The Medicare Payment landscape is shifting again, and for ACO leaders weighing whether to transition into the new LEAD model, the benchmarking methodology is where a large part of the decision lives. LEAD is not simply an updated version of ACO REACH or MSSP. It is a structurally different bet on a longer time horizon, […]
Navigating CMMI’s LEAD Model: How Is This Model Different from MSSP and ACO REACH?
The newly announced Long-term Enhanced ACO Design (LEAD) Model, details of which were released in the Request for Applications (RFA) on March 31, 2026, represents CMS’ commitment to design a more stable and inclusive framework to expand participation and advance accountability for cost and quality. For organizations considering ACO participation for Performance Year (PY) 2027, […]
CMS LEAD Model Update: What the Latest Webinar Clarified and What It Signals for Providers
With the LEAD (Long-term Enhanced ACO Design) RFA expected to drop in the coming weeks, CMS hosted a virtual Executive Session on Monday, March 23 with REACH participants to discuss changes since the last session and respond to questions from the audience. Here’s what you need to know. What’s New? LEAD introduces several structural and […]
LEAD (Long-term Enhanced ACO Design)
CMS recently held a webinar to provide additional details on LEAD, a new voluntary 10-year ACO opportunity running from January 1, 2027 through December 31, 2036. CMS Update: LEAD introduces several structural changes designed to address long-standing challenges in prior ACO models. Most notably, the model eliminates benchmark rebasing for the full 10-year performance period and implements […]
Federal Healthcare Policy Updates: Planning for Success in 2026-2027
Introduction Over the last 30 days, CMS and other federal agencies released several major policy and payment model announcements, many of which landed quietly over the holidays. While numerous regulatory updates were issued, three developments stand out as especially consequential for providers nationwide: Collectively, these recent developments emphasize four common themes that should guide strategic […]
LEAD ACO Model: Reviving the Promise of PC Flex
CMS recently announced the Long-term Enhanced ACO Design (LEAD) Model, positioning it as the follow-up to ACO REACH, which sunsets at the end of 2026. This 10-year voluntary model kicks off January 1, 2027, and promises the longest ACO model yet. LEAD isn’t just a REACH sequel – it is breathing new life into the goals […]
LEAD ACO Model: Reviving the Promise of PC Flex
CMS recently announced the Long-term Enhanced ACO Design (LEAD) Model.