Key Dates & Decision Points

This page summarizes major milestones from RFA release through Performance Year launch, and highlights factors organizations should weigh when evaluating LEAD participation.

Full Timeline (RFA §IV.A)

• March 31, 2026: RFA released, application portal opens
• April 20, 2026: Letter of Interest (LOI) form available for organizations interested in future cohorts
• May 17, 2026, 11:59 PM ET: Applications due for first cohort
• August 2026 (estimated): Financial guarantee templates released to accepted ACOs
• September 15, 2026: Implementation period begins
• December 31, 2026: Financial guarantee documentation due
• January 1, 2027: PY 2027 begins

ACOs that participated in ACO REACH for PY 2026 may submit an abbreviated application for the first LEAD cohort. (RFA §IV.A)

Decision Framework

Organizations evaluating LEAD should analyze model financials (benchmark trajectory, capitation elections, discount and add-on interactions; see benchmarking and capitation), risk tolerance (Professional vs. Global, corridors, stop-loss; see settlement), operational readiness (alignment, EHR, quality reporting, care management; see participation and quality), and overlap considerations with other CMS models at the TIN level (see participation).

Beneficiary Engagement and Marketing (RFA §VII.C)

LEAD ACOs must comply with beneficiary engagement and marketing requirements including:

• Providing beneficiaries with information about the model, their alignment status, and their rights
• Offering beneficiaries the opportunity to decline data sharing
• Following CMS-approved marketing guidelines
• Not engaging in activities that could mislead or coerce beneficiaries

ACOs must notify beneficiaries carried over from ACO REACH voluntary alignment attestations and provide opt-out instructions. (RFA §VII.C)

Data Sharing and Reports (RFA §XIII)

CMS will share data with LEAD ACOs to support care management and population health activities:

• Claims and claims line feed (CCLF) files for aligned beneficiaries
• Beneficiary-level alignment and eligibility data
• Preliminary and final benchmark reports
• Quality performance reports
• Shadow bundles data (for CARA preparation)

Beneficiaries may opt out of data sharing. Claims for opt-out beneficiaries are excluded from capitation fee reductions. (RFA §XIII.B)