Operational Infrastructure for the CMS LEAD Model
Build Your ACO Infrastructure for the 10-Year Model That Replaces ACO REACH
Care coordination, population health, and quality reporting for LEAD ACOs
Support for high-needs, dual-eligible, and homebound beneficiaries
Transition seamlessly from ACO REACH or enter accountable care for the first time
Production-ready in 4-6 weeks - not 6-12 months
The Ally Advantage
The Long-term Enhanced ACO Design (LEAD) Model is a 10-year voluntary CMS program launching January 1, 2027. It replaces ACO REACH when that model ends December 31, 2026, and represents CMS's longest and most comprehensive accountable care initiative to date. LEAD is designed to expand ACO participation by addressing the financial and administrative barriers that have kept smaller, rural, and independent practices out of accountable care.
The model offers a 10-year performance period with no benchmark rebasing, giving ACOs long-term financial predictability. ACOs choose between Global Risk (up to 100% shared savings and losses) or Professional Risk (up to 50% shared savings and losses).
Key features include enhanced cash flow through prospective payments, lower alignment minimums for new ACOs, add-on payments for small and rural providers, CARA episode-based specialist partnerships, dual-eligible integration pilot, Part D premium buy-down starting 2029, and benefit enhancements. Applications open March 2026 with the first performance year beginning January 1, 2027.
Why We're Different
Population Health Combine EHR, claims, and device data to identify high-risk cohorts. Drill into dual-eligibles, homebound, and high utilizers to target interventions where they impact total cost of care.
Care Coordination
Role-based AI guidance for care managers navigating complex patients across settings. Protocol-driven escalation paths, documentation checklists, and transition-of-care workflows.
CARA-Ready
Data sharing and coordination workflows for CARA episode-based arrangements. As CMS rolls out CARA, you'll have the interoperability infrastructure in place to participate.
Beneficiary Engagement Patient-facing communication in 120+ languages. Support for benefit enhancements and engagement incentives including prevention programs, healthy living rewards, and cost-sharing communication.
Quality Reporting
Track performance against LEAD quality measures including avoidable hospitalizations, ED utilization, gaps in care, and patient experience. Dashboard visibility before reconciliation.
Dual-Eligible Support
Care coordination, claims processing, engagement, and compliance infrastructure proven in D-SNP and I-SNP operations applies directly to LEAD's dual-eligible
integration goals.
The Problem
ACO REACH ends December 31, 2026. Organizations currently in REACH need to transition to LEAD or lose their accountable care infrastructure. Organizations that have never participated in an ACO model need to build that infrastructure from scratch. LEAD is more operationally demanding than prior models. CMS is explicit about the role of technology: the agency plans to identify priority technology use cases - care navigation, condition management, and population health analytics - and translate them into standardized business requirements.
The message is clear: accountable care at scale requires interoperable, standardized infrastructure, not disconnected point solutions. ACOs entering LEAD need to stand up care coordination workflows for attributed beneficiaries, build population health analytics to stratify risk and target interventions, support high-needs populations including dual-eligibles and homebound patients, track quality measures and total cost of care against benchmarks, manage beneficiary engagement incentives and benefit enhancements, prepare for CARA episode-based arrangements with specialists, and report outcomes that determine shared savings or losses.
Organizations that enter LEAD without this infrastructure will struggle to generate savings, fail quality thresholds, or face losses they cannot absorb.
The Solution
CareAlly supports LEAD ACOs whether you're transitioning from ACO REACH or entering accountable care for the first time. For current ACO REACH participants: The transition to LEAD requires continuity of existing care coordination and population health workflows, adaptation to new LEAD benchmarking and quality requirements, CARA readiness for specialist episode-based arrangements, dual-eligible coordination infrastructure already proven in SNP operations, and no operational disruption during the model switch. For organizations new to ACOs: LEAD is designed to bring in providers that have never participated in accountable care.
CareAlly provides the operational infrastructure you need to enter the model without building from scratch - deploy in 4-6 weeks, not 12 months. The platform integrates with your existing systems rather than replacing them, making it feasible for organizations without large IT departments. For small, rural, and independent practices: LEAD offers add-on payments, lower alignment minimums, and enhanced cash flow specifically for you.
CareAlly's platform works with what you already have. For organizations serving high-needs populations: If you serve dual-eligible, homebound, or complex patients, LEAD's improved risk adjustment and benchmarking work in your favor. CareAlly's care coordination and engagement tools are purpose-built for these populations.
The platform combines EHR, claims, and device data for population health analytics. Role-based AI guidance supports care managers navigating complex patients. Patient-facing communication operates in 120+ languages. Quality measurement tracks performance against LEAD measures before reconciliation. Claims management automates audit, error detection, and resubmission. AI assists with documentation, coordination, and reporting while clinical decisions stay with your team. Every output is auditable and traceable to source.