On March 31st, 2026, CMS released details on a new model called LEAD — the Long-term Enhanced ACO Design. It’s positioned as a replacement for ACO REACH. However, LEAD is not just an evolution of ACO REACH. It’s a fundamentally different proposition: a ten-year model with a fixed benchmark that never rebases, an integrated approach to…
Download Slides ACOs are only recently beginning to aggregate their patient data. Required to adopt data aggregation by new APP Reporting requirements, many now understand some of the difficulty with multiple EHRs. ACOs are now all too aware of the lack of practice staff capable of queuing up data or resolving data issues, and…
Download Slides If you’re a TEAM participant, you know the responsibility that comes with it: managing the cost of care and driving care delivery innovation across 30-day episodes for five surgical procedures. Yet many hospitals are struggling with one of the most complex — and often misunderstood — components of the model: target price…
In December 2025, the Centers for Medicare and Medicaid Services (CMS) announced the Long-term Enhanced ACO Design (LEAD) Model. Set to run from 2027 to 2036, the longest time horizon that CMS has tested to date, LEAD introduces several features to encourage coherent trajectories of care, including population-based payments, more predictable benchmarking, and episode-based risk arrangements to…
As value-based care continues to reshape the health insurance landscape, health plans face mounting pressure to evolve by continuing to become a true partner in care delivery. The shift demands more than operational adjustment — it requires a fundamental rethinking of how plans engage with providers, share data and measure success. To understand how health…
By Archana Gupta Dementia Is No Longer Peripheral to Value-Based Strategy Within most ACO populations, dementia quietly represents one of the most operationally complex and financially consequential cohorts. It is rarely the largest by diagnosis count, yet it disproportionately influences total cost of care, emergency department utilization, inpatient admissions, post-acute transitions, and long-term institutional…
Download Slides What does it really take to onboard new technology across dozens of hospitals? Successfully implementing change requires more than just the right technology — it demands clear governance, aligned decision-making, and thoughtful communication. In this 45-minute webinar, Julie Allen, System Director, Acute Case Management at Bon Secours Mercy Health, shares real-world insights…
As the Centers for Medicare and Medicaid Services (CMS) strives to improve and expand accountable care organization (ACO) models for the future, there’s a prime opportunity to better serve long-term care populations, including residents in nursing homes. For starters, the federal agency should consider simplifying the bureaucratic hurdles that keep more skilled nursing facilities (SNFs)…
In a recent letter to the Centers for Medicaid & Medicare Services, the National Association of ACOs (NAACOS) made several recommendations for how CMS could bring more innovation to the Medicare Shared Savings Program (MSSP). Aisha Pittman, M.P.H., NAACOS’ senior vice president of government affairs, spoke with Healthcare Innovation in detail about the policy recommendations to accelerate the adoption…
Columbia, S.C.-based Oasis Health Partners has acquired Premier Health, a healthcare administrative services organization specializing in revenue cycle management and practice operations, according to a March 19 news release. The acquisition expands Oasis’s platform for independent primary care practices, adding capabilities including value-based care contracting, analytics, clinical support, RCM and day-to-day operational services. The deal builds on…
In the last year, CMS has made strides to revamp health care through Medicare and Medicaid, taking some controversial steps. But one of their more positive moves involves changes to their Value-Based Care strategy. So, what does that strategy—through new or restructured payment models—tell us about where the system is headed? TEAM, ASM, ACCESS and…
The explicit theme of the recent Centers for Medicare & Medicaid Services quality conference was, “Making America Health Again: Innovating Together for Better Health.” The implicit theme was, “Speak Softly And Carry A Big Stick,” as agency leaders made clear they intend to use the $1.2 trillion in provider payment they control to make value-based…