The LEAD ACO RFA is now open. Application deadline: May 17, 2026. Talk to Pathways today.

What could LEAD mean for your practice?

Enter a few details about your practice to see an estimate of potential shared savings under the LEAD Model with Pathways.

Your Practice

1 250
50 800

National average: ~350 attributed Medicare beneficiaries per PCP

Performance Assumptions

1% (Conservative) 12% (Aggressive)

CMS reports median savings of 2-5% across ACO models. Pathways targets 4-8% through active care management.

0.60 (Healthy) 2.00 (Complex)

National FFS average: ~1.0. Higher-risk panels generate higher benchmarks.

Your Estimated Annual Practice Share

up to 70% of net shared savings

Per Provider
Net ACO Savings
Total Beneficiaries

Benchmark Details

PMPM Benchmark
Total Cost of Care (Annual)
Savings Rate Applied

The total cost of care benchmark reflects all Medicare spending (hospital, specialist, Part D, etc.) for your attributed beneficiaries -- not what your practice bills.

10-Year Practice Share Projection

Your estimated cumulative share over the full LEAD model. No benchmark rebasing means savings compound year over year.

Want a detailed, personalized projection based on your actual claims data?

Get a Custom Analysis

This estimator provides illustrative projections based on national averages and the assumptions you select. Actual results depend on patient acuity, utilization patterns, regional costs, and care management effectiveness. Contact Pathways for a data-driven analysis using your practice's actual claims.

How Pathways Outperforms

Our technology platform and clinical operations are purpose-built to drive savings in value-based care.

A

ALICE

ACO Intelligence Engine

ALICE is our AI-powered clinical intelligence platform embedded within the ACO Operating System (ACO-OS). It continuously analyzes claims, clinical data, and beneficiary patterns to surface actionable insights in real time.

Comprehensive Patient Analysis -- 9-segment deep-dive into every attributed beneficiary covering demographics, utilization, HCC gaps, care gaps, and more

HCC Risk Optimization -- Identifies undocumented and suspected conditions across all CMS-HCC segments, projecting RAF impact with provider attribution

Prevention Quality Indicators -- AHRQ PQI grouping detects preventable admissions and ED visits, targeting the highest-impact care interventions

Population Analytics -- PMPM trending, risk stratification, and cost variance analysis at the TIN, provider, and patient level

ACO-OS

ACO Operating System

The ACO Operating System is the operational backbone that powers Pathways. It integrates CMS claims data, clinical workflows, and financial analytics into a single platform purpose-built for accountable care.

Real-time Claims Processing -- CCLF data ingestion and analysis with automated quality scoring and data validation

CMS Benchmark Reconciliation -- Automated comparison of Pathways projections against CMS settlement reports to optimize financial performance

Episode Grouping & Fragmentation -- Clinical episode analysis identifying fragmented care patterns and network leakage

AWV & Quality Tracking -- Annual Wellness Visit eligibility tracking, care gap closure monitoring, and quality measure dashboards

While other ACOs rely on generic analytics platforms, Pathways built its own. ALICE and the ACO-OS are the reason we operate at full risk with confidence -- and why our partner practices benefit from insights no other ACO can provide.

Pathways Health Partners

See the real numbers.
Request a custom analysis.

This estimator uses national averages. Pathways can run a detailed projection using your practice's actual Medicare claims data -- at no cost, no obligation.

Request Custom Analysis