NAACOS Supports New CMS Innovation Center Total Cost of Care Model

Statement from Emily Brower, president and chief executive officer, the National Association of ACOs

WASHINGTON (December 18, 2025) – The National Association of ACOs applauds the Centers for Medicare and Medicaid Innovation Center’s new Long-Term Enhanced ACO Design (LEAD) model. The model’s 10-year timeline will allow participants to move past implementation to develop long-term investments and meaningfully innovate strategies that help move the transition to accountable care forward.

LEAD will introduce several enhancements that NAACOS has advocated for that will engage new providers and bring high-quality accountable care to more Medicare beneficiaries. Key design features include equipping all providers with the tools they need to care for patients with complex health needs, integrating Medicaid to improve data sharing and care coordination, and offering downstream value-based care arrangements to allow providers to design clinician teams that best support the populations they serve.

While these components will be beneficial to participants in the long run, launching the model in 2027 does not provide ACO REACH participants with enough time to evaluate alternative payment models options and effectively plan their transition. To that effect, CMS should extend ACO REACH through 2027 to set up a seamless glidepath for participants looking to remain in value-based payment models.

NAACOS and our members stand ready to partner with CMS to implement the LEAD model to improve seniors’ health outcomes and sustain robust provider participation as we work collectively to advance accountable care.

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The National Association of Accountable Care Organizations (NAACOS) is a member-led, member-governed nonprofit of nearly 500 ACOs and value-based care entities in Medicare, Medicaid, and commercial insurance working on behalf of physicians, health systems, and other providers across the nation. These value-based care providers seek to improve the quality of care while reducing costs. NAACOS represents more than 9 million beneficiary lives through Medicare’s population health-focused payment and delivery models.