RFA Released -- Recruiting Practices for PY 2027

The Future of Medicare is LEAD

A 10-year model designed for independent practices ready to deliver better care and share in the savings. Your practice stays yours. We handle the rest.

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The LEAD Model at a Glance

Year Commitment

The longest ACO model CMS has ever tested. Invest in transformation with confidence.

No Benchmark Rebasing

Keep the value of your care improvements. Your savings are your savings.

Built for Independents

Lower alignment minimums, rural add-on payments, and support designed for your practice size.

Prospective Payments

Predictable, capitated revenue instead of fee-for-service uncertainty.

ACO REACH Participant CMS Innovation Center Value-Based Care

Live Savings Estimator

What could LEAD mean for your practice?

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Tell us about your practice

Primary Care Providers

1 50

Medicare Patients per Provider

50 800

National average: ~350 attributed Medicare beneficiaries per PCP

Expected Savings Rate

1% (Conservative) 12% (Aggressive)

Pathways targets 4-8% through active care management.

Your Estimated Annual Practice Share

up to 75% of net shared savings

10-Year Cumulative

Total Beneficiaries

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A Different Kind of Partner

We go where your busy practice can't

Our business is the business of healthcare. We extend your practice to every setting your patients move through -- the hospital, the SNF, and the home.

Hospital & ER Coordination

When your patients are admitted at 2 AM, we're there. Our team coordinates directly with hospitalists and ER providers, managing transitions and ensuring your patients return to your care -- not to a readmission.

ADT Alerts Discharge Planning Readmission Prevention

SNF & Post-Acute Management

We actively manage your patients through skilled nursing and rehab, tracking recovery milestones and accelerating safe transitions home. Shorter stays, better outcomes, lower cost.

Recovery Tracking Length-of-Stay Reduction Transition Planning

Skilled Care at Home

In LEAD and ACO REACH, your patients can receive skilled nursing at home without a homebound requirement. That means post-discharge visits, chronic disease monitoring, medication management, and care gap closure -- all in the patient's home, at a fraction of the cost of a facility stay.

No Homebound Requirement Disease Management Care Gap Closure

Why Now

The RFA is live. PY 2027 starts January.

CMS has released the LEAD Model Request for Applications. Pathways is submitting an abbreviated application as a Renewing ACO on the Global Risk Option this Summer 2026 -- and recruiting Participant Practices and Preferred Providers throughout 2026 ahead of the Performance Year 2027 launch.

This is the first cohort. Early participants lock in their benchmarks for the full 10 years with no rebasing -- a decade-long model designed to reward the care you're already delivering.

Understand the LEAD Model

2027

Model Launch Year

10yr

Model Duration

Cost to Participate

100%*

Shared Savings (Global)

ACO retains 100% of shared savings on the Global Risk track with no minimum savings rate. Subject to a 2% quality withhold and applicable CMS discount (1.75%-3% for higher-spending ACOs). Pathways absorbs all downside risk -- participating practices are not exposed to losses. Practice share is set in the participation agreement.

Our Business Is the Business of Healthcare

Your practice. Our infrastructure.
Better outcomes, together.

We don't just manage risk -- we manage care. From the hospital to the home, we give your patients the support they need and your practice the results it deserves.

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