COPE Health Solutions

You asked. We answered. Our recent LEAD Readiness Room webinar answered questions from organizations evaluating participation in the new LEAD model. Key themes from the discussion and questions submitted include: ✔️  High-needs beneficiaries are now central to the model, creating new opportunities for organizations that can effectively identify, engage and manage complex patient populations. ✔️ Financial flexibility is expanding through global risk, primary care capitation and specialty engagement options that create earlier cash flow and stronger alignment across care teams. ✔️ While opportunity is significant, uncertainty remains — particularly around rate book methodology, AI-informed risk adjustment and high vs. low-cost ACO designation. Success under LEAD will require more than strategy alone. Organizations will need strong infrastructure, actionable data, provider alignment and thoughtful financial modeling to succeed.   Read the full recap here: https://lnkd.in/gJc_Sngw #accountablecare #valuebasedcare Bridgette Wiefling Danielle Feldman, MPA

We’re excited to host a Q&A forum on Tuesday, May 5 to help ACOs navigate the LEAD model and application. This session is designed to address the questions that still remain as we approach the May 17 application deadline. Whether you’re navigating the latest updates to the LEAD RFA, application requirements, or evaluating capabilities required for success, join us for real-time insights to help you move forward with clarity and confidence. 📅 Tuesday, May 5 ⌚ 12 p.m. ET 📍 Register here: https://lnkd.in/eumW-HQc #valuebasedcare #accountablecare Les Duncan Bridgette Wiefling Theresa Dreyer Steven R. Carson, MHA, BSN, RN

If you haven't signed up, don't miss out on our webinar in 2 days: Preparing for RHT, TEAM, and the Future of Rural Value-Based Care Converging state and federal priorities are driving rapid shifts in the rural health landscape in California. With initiatives like the $50B Rural Health Transformation program delivering $233 million to the state and the mandatory TEAM model for select counties, 2026-2027 will emerge as a pivotal inflection point for rural health delivery and will usher in a new era of rural value-based care in California. In this webinar, we’ll discuss: ➡️ Why 2026–2027 is a turning point for rural health in California. ➡️ The policy landscape driving health transformation in California, including RHT, ACCESS, LEAD, MSSP, and the Mandatory TEAM Model in select California counties. ➡️ What these changes mean specifically for rural providers and how to prepare to succeed in these new models. 📅 April 29 ⏰ 10 a.m. PT 📍 Register here: https://lnkd.in/e4uZT8EU #valuebasedcare #ruralhealth

Don’t forget to register for the LEAD Readiness Room webinar on May 5. Join us for a Q&A forum offering real-time guidance to navigate the LEAD model and application. This session is designed to address the questions that still remain as we approach the May 17 application deadline. Whether you’re navigating the latest updates to the LEAD RFA, application requirements, or evaluating capabilities required for success, join us for real-time insights to help you move forward with clarity and confidence. https://lnkd.in/eumW-HQc

Don't miss out on this upcoming Webinar: Preparing for RHT, TEAM, and the Future of Rural Value-Based Care Converging state and federal priorities are driving rapid shifts in the rural health landscape in California. With initiatives like the $50B Rural Health Transformation program delivering $233 million to the state and the mandatory TEAM model for select counties, 2026-2027 will emerge as a pivotal inflection point for rural health delivery and will usher in a new era of rural value-based care in California. In this webinar, we’ll discuss: ➡️ Why 2026–2027 is a turning point for rural health in California. ➡️ The policy landscape driving health transformation in California, including RHT, ACCESS, LEAD, MSSP, and the Mandatory TEAM Model in select California counties. ➡️ What these changes mean specifically for rural providers and how to prepare to succeed in these new models. 📅 April 29 ⏰ 10 a.m. PT 📍 Register here: https://lnkd.in/e4uZT8EU #valuebasedcare #ruralhealth

The NAACOS Spring Conference is underway! COPE Health Solutions is here and excited to be part of the discussions shaping the future of value-based care. If you’re here, stop by and see us at Table 22. We’d love to connect and hear what’s top of mind for you during the conference. If you’re considering LEAD, visit us to learn how we can help you navigate the critical decisions you’re facing and support your application process. #NAACOS #NAACOSSpring2026 Les Duncan Kathryn Honeycutt

Upcoming Webinar: Preparing for RHT, TEAM, and the Future of Rural Value-Based Care Converging state and federal priorities are driving rapid shifts in the rural health landscape in California. With initiatives like the $50B Rural Health Transformation program delivering $233 million to the state and the mandatory TEAM model for select counties, 2026-2027 will emerge as a pivotal inflection point for rural health delivery and will usher in a new era of rural value-based care in California.   In this webinar, we’ll discuss: ➡️ Why 2026–2027 is a turning point for rural health in California.  ➡️ The policy landscape driving health transformation in California, including RHT, ACCESS, LEAD, MSSP, and the Mandatory TEAM Model in select California counties. ➡️ What these changes mean specifically for rural providers and how to prepare to succeed in these new models. 📅 April 29 ⏰ 10 a.m. PT 📍 Register here: https://lnkd.in/e4uZT8EU #valuebasedcare #ruralhealth Bridgette Wiefling Allison Blakemore, MPH

Today CMS announced revisions to the LEAD RFA. Notable revisions include:   ➡️ Both High Needs and ESRD beneficiary categories will count towards the 40% alignment threshold for an ACO to qualify for lower beneficiary alignment minimums. ➡️ To calculate the regional efficiency adjustment, CMS will compare ACO’s historical baseline benchmark to average Medicare spending in the ACO’s region in Base Year 3. CMS will calculate the difference separately for each beneficiary category, and then combine these amounts into a single, population-weighted adjustment. ➡️ Benchmark adjustments will be capped at 3% of risk-standardized USPCC for lower-spending ACOs that have participated in the Shared Savings Program within the previous two years. ➡️ Higher-spending ACOs that have participated in the Shared Savings Program within the previous two years will have their benchmark adjustment (when relevant) capped at 5% of risk-standardized USPCC. Our ACO strategy team is available to guide you through the LEAD RFA process. If you have any questions about today’s round of updates, reach out to schedule a briefing: https://lnkd.in/esZS-EVE A full summary of the revisions is available on the CMS website: https://lnkd.in/g-QuwC-Z

As organizations evaluate whether to enter into the new LEAD model, the benchmarking methodology is where much of the decision lies. LEAD is not simply an updated version of ACO REACH or MSSP. It is a structurally different bet on a longer time horizon, and the organizations that benefit most will be those who understand exactly how their benchmark is built, trended, and eventually replaced.   In this article, we dig into: ✅ How Your Baseline Is Built — and Why It May Be Higher Than You Think ✅ ACO-Specific Benchmark Adjustments ✅ The Long-Term Horizon — Regional Rate Book Transition ✅ Strategic Decision Framework — MSSP vs. REACH vs. LEAD Check it out here: https://lnkd.in/enEQVNN6 Ankita Shah, MBA Les Duncan #valuebasedcare

The newly announced Long-term Enhanced ACO Design (LEAD) Model aims to establish a more stable and inclusive framework to expand participation and advance accountability for cost and quality. If you’re considering participating for Performance Year 2027, it is critical to understand the key success factors that differentiate LEAD from MSSP and ACO REACH. Model comparison – in short: MSSP – The broad, flexible entry point into value‑based care for original FFS Medicare. ACO REACH – The full‑risk, equity‑focused model for advanced organizations. LEAD – CMS’s next‑generation, capitation‑driven, specialist‑integrated, highneeds‑focused ACO model. Dig deeper: Review the full, detailed comparison of the three models across key dimensions like payment models, beneficiary alignment, and care delivery requirements: https://lnkd.in/gzva6RdF #valuebasedcare #accountablecare