What the LEAD model is
LEAD is a 10-year accountable care model for traditional Medicare, announced by CMS on December 18, 2025. It starts January 1, 2027, the day after ACO REACH ends. ACOs pick Global Risk, with up to 100% of savings or losses, or Professional Risk, with up to 50%. The model offers capitated, population-based payments.
The long term is the point. LEAD sets a 10-year benchmark pathway with no rebasing, so savings are not erased by a reset benchmark. It adds CMS-Administered Risk Arrangements (CARA) for optional ACO-specialist episodes and a falls-prevention episode. It also includes Part B cost-sharing support and a Part D premium buy-down by 2029.
CMS aimed LEAD at small, rural, and independent practices, federally qualified health centers, and current REACH ACOs. A decade of accountability for aligned patients means steady data and outreach work. Rivvi gives ACO teams one HIPAA-compliant AI workspace to analyze alignment and gap files and reach patients by phone and text.