What is the contracting deadline for the LEAD Model?

The contracting deadline for the LEAD Model is September 2026.

When is the roster submission deadline for LEAD?

The roster submission deadline for the LEAD Model is August 2026.

CONTRACTING DEADLINE: SEPTEMBER 2026

The Next Era of Accountable Care Is Taking Shape

Get Ahead of the LEAD Model

The CMS Long-term Enhanced ACO Design (LEAD) Model launches January 1, 2027 — and the organizations that will thrive are the ones preparing now.

Pearl has been deep in the methodology. We're actively analyzing LEAD's financial framework, risk structure, and operational requirements so you don't have to start from scratch. The result: clear, actionable intelligence on how your network would perform under the new model — before the rules are fully set.

Request your complimentary LEAD readiness analysis and get the grounded perspective your strategy deserves.

Key LEAD Dates to Know

The window to prepare is tighter than it seems. Pearl is ready to guide you every step of the way:

March

RFA Released

Pearl tracks CMS’s official program details and participation requirements so you don’t miss a beat.

Mid-April

Strategic Thought Partnership

We partner closely with you to pressure-test participation decisions and explore both LEAD and MSSP pathways ahead of underwriting release.

Late-April

Deep Dive Analysis

We break down RFA implications for underwriting, benchmarking, and risk strategy—so you can plan with confidence.

May

Directional Guidance

Pearl provides directional underwriting guidance to keep your strategy on track.

June / July

Underwriting Ready

Our LEAD underwriting tools and insights are ready to support your decision-making.

August

Roster Submission Deadline

Pearl helps you finalize and submit participant lists accurately and efficiently—timely submission is required to enable September contracting.

September

Contracting Deadline

We ensure participation agreements are executed seamlessly.

Pearl’s experts are unpacking the LEAD transition—actuarial, clinical, and operational insights delivered straight to you, so you can focus on acting, not analyzing

The LEAD RFA is Here

The LEAD RFA resolves many structural unknowns from CMS's new ACO model, introducing novel mechanisms — a static baseline, three-way trend blending, AI-inferred risk adjustment, and specialty episode arrangements. But the complexity of interacting components means credible underwriting requires new actuarial tools, not adjustments to existing REACH or MSSP models.

Why You (Probably) Shouldn't Trust Early Underwriting on LEAD

Early projections for LEAD may look precise, but critical structural details remain unresolved. Until those mechanics are clear, confident underwriting forecasts should be treated with healthy skepticism.

The Road to 2027: Breaking Down the New CMS LEAD Model

CMS’s new LEAD Model will replace ACO REACH in 2027, offering a 10-year value-based care framework with stable benchmarks, new risk tracks, targeted populations, and innovations, while key technical details await the 2026 RFA.

HHS Seeks Input on Systemic Approach to Healthcare AI Regulation

Following a new Executive Order, HHS has issued a sweeping RFI on healthcare AI—inviting stakeholders to shape future regulation, reimbursement, and governance at a critical, formative moment for clinical AI adoption.

Long-term Enhanced ACO Design (LEAD) Model: Request for Applications

ACOs can now apply to participate in the LEAD Model—an important step forward in the Innovation Center’s accountable care work to support a broader mix of health care providers and Medicare beneficiaries.

CMS Announces the LEAD Model: A New Long-Term ACO Option Beginning in 2027

CMS announced the Long-term Enhanced ACO Design (LEAD) Model, a new voluntary 10-year ACO model set to replace ACO REACH starting January 1, 2027. The model aims to provide a stable, long-term pathway for both new and existing ACOs, with a significant focus on encouraging participation from smaller, independent providers and those serving complex, underserved populations.

LEAD (Long-term Enhanced ACO Design) Model | CMS

CMS announced the new LEAD (Long-term Enhanced ACO Design) Model, an ACO-focused initiative launching after ACO REACH concludes at the end of 2026. This signals a long-term commitment to evolving value-based care models, building on previous programs to enhance provider accountability and care coordination.

What the LEAD Model Means for Your Practice

When will I know what this means for my practice specifically?

Pearl is currently analyzing the LEAD program rules to determine how they affect each practice's financial outlook. Individual underwriting — meaning the specific financial projections for your practice under LEAD — won't be available until this summer. We'll share directional guidance on how LEAD compares to MSSP for practices like yours in the coming weeks, well before you need to make any decisions.

‍

What is the LEAD model?

LEAD (Long-term Enhanced ACO Design) is a new Medicare ACO program from CMS that launches on January 1, 2027. It replaces ACO REACH, which ends on December 31, 2026. If you're currently working with Pearl in ACO REACH, LEAD is what comes next. If you're currently in MSSP with Pearl, LEAD is a new option to consider alongside continuing in MSSP.

Do I need to apply to LEAD myself?

No. Pearl handles the application, ACO setup, and CMS relationship. Your role is to work with your Pearl team to decide whether LEAD or MSSP is the best fit for your practice, and to complete the steps needed to participate — similar to what you do today.

What are the key decision deadlines?

You do not need to make a final decision right now. Here's the general timeline:

Now through early summer: Pearl is analyzing the program and preparing recommendations. You'll receive educational materials and have conversations with your market team about what's changing and what isn't.
Summer 2026: Underwriting results will be available. This is when you'll be able to see projected financial performance under LEAD and compare it to MSSP. Pearl will walk you through your options.
Late summer / early fall 2026: Decision point for which program and track to participate in for 2027.
January 1, 2027: LEAD begins. ACO REACH ends.