Cms Announces Lead Model, Focusing On Homebound Patients

On Thursday, the Centers for Medicare and Medicaid Services (CMS) announced a new accountable care organization (ACO)- focused model, specifically targeting homebound and dually eligible patients.

The 10-year voluntary program, called the Long-term Enhanced ACO Design (LEAD) Model, is set to launch after the ACO Realizing Equity, Access, and Community Health (REACH) program ends on Dec. 31, 2026. The new program creates opportunities for home-based care providers to establish new partnerships and strengthen others. 

The LEAD model seems to essentially be the next iteration of the ACO REACH, according to Hillary Loeffler, vice president of policy and regulatory affairs at the National Alliance for Care at Home (the Alliance).

“In this go around, there seems to be more focus on folks that are homebound and have difficulty leaving the home, trying to reach more of those high-severity patients,” Loeffler said. “So we’re super optimistic about that, because that’s definitely the type of patients we care for in the home setting.”

The LEAD model aims to increase the number of small, rural and independent health care providers and Community Health Centers as ACOs, according to CMS. It is also designed to emphasize preventive care, giving health care providers the flexibility to check in with patients regularly and coordinate care in between visits.

The program will provide flexible, capitated, population-based payments designed to support team-based care and downstream value-based care arrangements.

While the Alliance is optimistic about LEAD, “the devil is in the details,” Loeffler said.

“So we’re just going to keep our eye out for when CNS releases the request for applications, just to see if we can get more information,” she said. “But at the same time, [we are] pretty excited, because they don’t often target their models towards our patient population specifically. There are a lot of models that touch on our space, but this one, it seemed, was very much focused on our patient population. Super pleased to see that there’s some attention given to our high needs patient populations.”

For home-based care providers, the LEAD opportunity will be similar to the opportunity currently available through ACO REACH, both of which are geared towards ACOs as being responsible for the total cost of care.

“Where our providers come in as they’re going to be partnering with ACOs and hopefully helping patients stay in their preferred location, which is in the home,” Loeffler said. “We think it’s a pretty good opportunity to establish new partnerships that might not be there with ACOs and other provider types, or just strengthen existing ones that we already have.”

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