CMS opens applications for new LEAD model In December, CMS announced a new Medicare accountable care organization (ACO) model called LEAD. The LEAD model replaces the ACO REACH model, which was originally introduced in 2022 and will end in December 2026. LEAD, which will begin Jan. 1, 2027, is a voluntary, 10‑year model designed to…
Historically, policy makers have faced challenges implementing accountable care in rural communities. Rural facilities and delivery organizations can face financial challenges, workforce shortages, and financial volatility. Facility closures and limited clinician availability can constrain access and choice and lead to long patient travel distances. These factors make rural accountable care especially sensitive to infrastructure gaps. In turn, rural…
This FAQ is based on our March 25, 2026 webinar “Taking the LEAD on CMS Policy Updates for VBC Excellence” and has been updated to reflect policy finalization through April 8, 2026. Note: The application process for LEAD is expected to be competitive – meeting eligibility criteria does not ensure acceptance. Current ACO REACH PY 2026 participants may…
Evergreen Nephrology, which works with practices on value-based payment models for kidney care, operates across 24 states with a network of over 1,000 providers. Scott Lloyd, the company’s chief development & strategy officer, recently spoke with Healthcare Innovation about the importance of provider buy-in for value-based care. We were joined by Britt Newsome, M.D., M.P.H., chief medical…
Editor’s note: This is the third article in a series about CMS’ new LEAD model. Article one explored the new model in broad strokes. Article two discussed AI-Inferred Risk Adjustment. Future posts will explore CMS-administered risk arrangements and beneficiary enhancements. LEAD, CMS’ ten-year bet on accountable care, replaces ACO REACH, a model planned to sunset on December 31,…
In this episode, Gabriel Scott, Kevin Alonso, and Kennedy Caldwell break down the new Long Term Enhanced ACO Design (LEAD) Model and its impact on accountable care. They provide background on the model, outline key new features, and discuss five issues that Accountable Care Organizations and providers should consider as they evaluate participation. Listen to…
New research from the Harvey L. Neiman Health Policy Institute found that most Merit-Based Incentive Payment System (MIPS) quality measures designated as “topped out” by the Centers for Medicare & Medicaid Services (CMS) were reported by only a small fraction of eligible physicians, suggesting these measures may not reflect consistently high performance across clinicians. Topped…
Over the past decade, the oncology community has generated a tremendous amount of evidence on the multitude of benefits of embedding supportive health care delivery interventions within clinical workflows of oncology providers.1-5 Despite the undeniable improvements in cost, quality, and patient experience, these programs, including formalized lay navigation and psychosocial support as well as proactive…
Download Slides Reducing hospital readmissions remains a central goal of value‑based care, yet many effective solutions are difficult to scale due to cost or operational burden. ilumed and Connective Health have pioneered a different approach that reduced hospital readmissions in Q4 2025 from 16% to 11% (27.5% reduction). By rethinking post‑discharge workflows, this program…
Download Slides Surgical care is one of the most significant drivers of cost, outcomes, and financial performance in value-based healthcare. Yet many surgical complications, readmissions, and same-day cancellations are not random—they are predictable and preventable. In this webinar, we’ll explore how predictive-prevention platforms are transforming perioperative care by enabling hospitals to identify high-risk patients…