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While there’s a lot of room for improvement in the ACO model, the Centers for Medicare and Medicaid Services (CMS) has found that even the existing model has the potential to coordinate care at scale, something that hasn’t really existed in Medicare FFS before. And “spillover effects” from ACOs have helped promote widespread adoption of innovative care delivery options across payers and beneficiaries, according to Purva Rawal, recent past chief strategy officer for the CMS Innovation Center at the Centers for Medicare and Medicaid Services (CMS).
“The program needs to go further. It needs to be bringing in more providers like SNFs into the continuum, creating that new proposition for downstream providers as well … I think we’ll see some of that, maybe in the new CMMI LEAD model,” said Rawal, referring to the CMS Long-term Enhanced ACO Design, or LEAD. LEAD is a 10-year, voluntary program launching in January 2027. More ACO use could add competitive pressure with Medicare Advantage plans too, making FFS a more viable option for beneficiaries.