With the release of the 2027 Medicare Advantage (MA) advance notice in January 2026, the Centers for Medicare and Medicaid Services (CMS) demonstrated they were willing to implement a bold agenda that defied public and market expectations. Looking ahead, Director of Medicare and Deputy Administrator of CMS Chris Klomp has made it clear that he wants to…
It’s a new world for ACOs, especially those just immersing in aggregated patient data. Once a rarity for ACOs to look beyond claims data for population health and analytics, ACOs are now finding themselves at the center of a data need surge. The transition from easy, manual quality reporting for a sample of ACO patients…
CARLSBAD, Calif. and SPRINGFIELD, Ore., April 21, 2026 /PRNewswire/ — Ceresti Health, a national leader in tech-enabled dementia management, and PacificSource, an independent, not-for-profit community health plan serving the Northwest, today announce first year cost savings attributable to Ceresti’s dementia management program. Medicare Advantage plans are facing one of the most challenging financial environments in years as flat payment…
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…
Over the past two years, healthcare leaders have shifted from questioning whether and where gen AI is relevant to focusing on how it can be used responsibly and at scale. Our latest survey of US healthcare leaders highlights several signals of gen AI’s maturation: Half of leaders report that their organizations have already implemented gen AI,…