CMS has announced the launch of its newest accountable care organization model with the goal of providing a better way for primary care physicians and specialists to collaborate more closely to deliver coordinated care for patients, the American Medical Association reported Dec. 22.
Here are five things to know about the new program:
1. The “Long-term Enhanced ACO Design” is set to launch at the end of 2026 and comes after years of recommendations by the AMA.
2. LEAD aims to provide an improved benchmarking process to appeal to a wider mix of physicians. The program has been designed for practices that have previously participated in an ACO model as well as newcomers to the program.
3. The 10-year performance period will provide stability for physician participants and offer more sufficient time for them to gain experience and enhance the way they deliver patient care. The new model also focuses on improved care for patients with complex needs, including those who are dually eligible for Medicare and Medicaid and are homebound or home-limited.
4. Under the global risk option, practices are eligible to receive up to 100% of their savings and liable for up to 100% of total losses relative to their established performance benchmark. Under the professional risk option, practices are eligible to receive up to 50% of total savings and liable for up to 50% of total losses relative to their established performance year benchmark.
5. CMS Administered Risk Arrangements will provide “robust” CMS support to ACOs to enable episode-based risk arrangements between ACOs and their specialist and provider organization, according to the AMA.
