The Centers for Medicare & Medicaid Services (CMS) has released an updated Request for Applications (RFA) for the Long-term Enhanced ACO Design (LEAD) Model. Healthcare organizations interested in value-based care should act quickly. Applications are due May 17, 2026. To help prospective applicants, CMS will also host a dedicated office hour on April 21, 2026, at 1 p.m. ET.
What Is the LEAD Model?
Understanding Long-term Enhanced ACO Design
The LEAD Model is a CMS innovation initiative designed to advance accountable care across the healthcare system. It builds on the Accountable Care Organization (ACO) framework. Specifically, it targets long-term care and care coordination improvements within Medicare. The model encourages providers to deliver high-quality, cost-effective services over extended periods.
Moreover, LEAD aligns financial incentives with patient outcomes. This approach reduces unnecessary utilization and promotes preventive care strategies. Healthcare organizations that participate can benefit from shared savings opportunities. Therefore, the model represents a significant step forward in value-based payment reform.
Key Updates to the Application
What Changed in the Latest RFA
CMS revised the LEAD Model Request for Applications to reflect updated program priorities. The agency made changes to eligibility criteria, participation requirements, and financial benchmarks. Additionally, CMS refined the quality measurement framework. These revisions aim to make the model more accessible to a wider range of healthcare organizations.
Prospective applicants should review the updated RFA carefully. The revised document clarifies how CMS will evaluate applications. Furthermore, it outlines key expectations around care delivery and reporting obligations. Organizations that reviewed an earlier version of the RFA must revisit the latest release.
Application Deadline and Eligibility
Who Can Apply and When
Applications are due May 17, 2026. Eligible organizations include physician group practices, hospitals, and other Medicare-enrolled providers with experience in care coordination. Applicants must meet specific structural and operational criteria outlined in the updated RFA.
Importantly, organizations should confirm their eligibility before investing time in the full application. CMS has clarified eligibility rules in the updated document. Consequently, some organizations that may have been uncertain about qualifying should revisit the criteria. Early preparation significantly improves the quality of a final submission.
Office Hour Details for Applicants
April 21 Webinar: What to Expect
CMS will host a live office hour session on April 21, 2026, at 1 p.m. ET. This session targets prospective LEAD Model applicants. During the call, CMS representatives will address frequently asked questions across several topics. These include eligibility, participation requirements, financial methodology, quality measures, and the application timeline.
Additionally, applicants can submit questions in advance through the registration portal. This option allows organizations to receive targeted guidance tailored to their specific situation. Attending this session is strongly recommended for any organization considering applying. In fact, it may be one of the most valuable resources available before the May deadline.
Financial Methodology and Quality Measures
How CMS Evaluates Performance
The LEAD Model uses a performance-based financial framework. CMS rewards participating organizations for reducing costs while maintaining or improving patient outcomes. The updated RFA provides greater detail on how financial benchmarks are calculated. Organizations should study this section closely before finalizing their application.
Quality measures under LEAD focus on care coordination, patient experience, and preventive care utilization. CMS ties shared savings directly to performance on these measures. Thus, applicants must demonstrate a strong infrastructure for data collection and quality improvement. Organizations with existing quality programs are better positioned to succeed under this model.
How to Prepare Your Application
Practical Steps Before May 17
Start by downloading the updated RFA from the CMS Innovation Center website. Next, conduct an internal eligibility assessment using the criteria listed in the document. Then, identify your care coordination capabilities and align them with LEAD requirements.
Register for the April 21 office hour and submit questions in advance. This allows your team to clarify any concerns before drafting the full application. Furthermore, engage clinical and financial leadership early in the process. A cross-functional team produces stronger, more comprehensive submissions. Finally, allocate sufficient time for review and revision before the May 17 deadline.
Why the LEAD Model Matters for ACOs
Advancing Value-Based Care in Medicare
The LEAD Model represents CMS’s continued commitment to reforming how Medicare pays for care. Value-based models like LEAD reduce the system’s reliance on fee-for-service payments. Instead, they reward providers for outcomes, efficiency, and long-term patient management.
For ACOs and healthcare organizations, participating in LEAD creates both financial opportunity and clinical accountability. Beyond savings, it encourages a culture of quality improvement across care teams. As Medicare continues to shift toward value-based payment, models like LEAD will play an increasingly central role. Organizations that engage now position themselves ahead of the curve.
