CMS has announced the Long-term Enhanced ACO Design (LEAD) Model, a new voluntary accountable care organization (ACO) initiative from the CMS Innovation Center scheduled to begin in 2027.
Designed as a 10-year model, LEAD is intended to broaden participation in accountable care by attracting providers who have historically faced barriers to ACO engagement, including smaller practices, rural providers and organizations serving patients with complex or high-needs conditions.
The LEAD Model reinforces CMS's strategic focus on value-based care, prevention and coordinated services across settings. Of particular relevance to RDNs, the model includes new Benefit Enhancements and Beneficiary Engagement Incentives that promote healthy living and more proactive management of chronic disease.
Notably, the model expands access to medical nutrition therapy beyond the current statutory limitations of diabetes and chronic kidney disease for beneficiaries aligned to certain LEAD ACOs.
This reflects growing recognition of nutrition as a foundational component of chronic disease prevention, improved clinical outcomes, and healthy aging, and represents an important step toward better aligning Medicare policy with the evidence supporting nutrition intervention across a wider range of conditions that can be positively impacted by MNT.
The model's extended time frame and financial framework may also enable participating organizations to invest more meaningfully in preventive services, interdisciplinary care teams, and community-based supports.
CMS anticipates releasing a request for applications in March 2026, with the model set to run from January 1, 2027, through December 31, 2036. Early planning efforts will also examine opportunities to strengthen Medicare-Medicaid integration in select states, along with new approaches to risk sharing and beneficiary incentives.
The Academy will continue to monitor developments related to the LEAD Model and will share additional guidance as details become available, with particular attention to implications for nutrition services, MNT coverage, and the role of RDNs within ACO care teams.
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