This whitepaper explains the CMS Long-term Enhanced ACO Design CMS LEAD Model, a 10-year accountable care program launching January 1, 2027, to replace ACO REACH. It breaks down why CMS created LEAD, how the model works, and what makes it fundamentally different from previous ACO iterations.
The paper examines the critical changes LEAD introduces, including stable benchmarks that don’t reset for a decade (eliminating the ratchet effect that penalized high performers), CARA (CMS Administered Risk Arrangements) that finally make specialist integration administratively feasible, and infrastructure support designed specifically for small practices, rural providers, and community health centers. It outlines the two risk tracks (Global and Professional), participation requirements, and the tight timeline organizations face with applications opening in March 2026.
Download this whitepaper to understand whether LEAD is the right path for your organization, what infrastructure and financial reserves you need to succeed, and how to prepare during the critical 13-month decision window before the model launches