ACOs can now apply for Medicare’s LEAD model

Applications are now open for accountable care organizations (ACOs) interested in Medicare’s new Long-term Enhanced ACO Design (LEAD) model. The Centers for Medicare & Medicaid Services (CMS) expects there will be future opportunities to apply for the model, but it strongly encourages those interested to apply by May 17 to participate in the first cohort.

LEAD, a 10-year model that runs from Jan. 1, 2027, through Dec. 31, 2036, builds on the previous Realizing Equity, Access, and Community Health (REACH) model, which ends after this year. Current REACH participants, other ACOs, and practices that have not previously been in an ACO are eligible to participate. CMS hopes to increase the scope of participants in their ACO models to include more small, rural, and independent practices and Community Health Centers.

Additional information is available in the following resources:

• LEAD home page
• Request for applications
• Application checklist
• Payment fact sheet
• LEAD model overview
• LEAD model value fact sheet
• CMS-administered risk arrangements fact sheet

To sign up for LEAD updates, subscribe to the LEAD Model listserv.

The Center for Medicare & Medicaid Innovation is holding an informational webinar about the request for LEAD applications 2 to 3 p.m. ET April 9. The webinar will discuss eligibility and participation requirements, financial methodology, quality reporting, and the application process and timeline.

(For other new payment model options, see "CMMI Releases Nine New Payment Models.")

— Erin Solis, Manager, Practice & Payment at the American Academy of Family Physicians

Posted on April 1, 2026