Current status and final year
The ACO REACH model page says the model was redesigned from the Global and Professional Direct Contracting Model, which ran for performance years 2021 and 2022. ACO REACH's first performance year began on January 1, 2023, and it runs for four performance years, 2023 through 2026. The LEAD model page says LEAD is set to launch following the conclusion of ACO REACH at the end of 2026.
The model summary on the ACO REACH page lists the stage as Active, under section 1115A of the Social Security Act. The participant section says that in performance year 2026, 74 ACOs are participating, in all 50 states, the District of Columbia, and Puerto Rico, and that ACO REACH will not accept new applications for the remaining model duration.
CMS offers two voluntary risk-sharing options on that page. Professional is 50 percent of savings and losses, paid through Primary Care Capitation. Global is 100 percent of savings and losses, paid through Primary Care Capitation or Total Care Capitation. Participant types on the page are Standard ACOs, New Entrant ACOs, and High Needs Population ACOs.
The successor CMS has named
The LEAD model page calls the Long-term Enhanced ACO Design (LEAD) Model a successor to ACO REACH. LEAD is a 10-year voluntary model that runs from January 1, 2027, through December 31, 2036. The model summary lists the stage as Announced. CMS says it offers Global risk, up to 100 percent of savings and losses, and Professional risk, up to 50 percent of savings and losses, with capitated population-based payments.
The same page says CMS anticipates LEAD participants will include current ACO REACH participants and other ACOs, Medicare fee-for-service providers that have not historically been in ACOs, and providers serving underserved populations. This page does not name any successor other than the one CMS names on the LEAD page.