Listen to the AMA’s new podcast on the LEAD model, featuring CMMI leaders
CHICAGO – The American Medical Association (AMA) applauds the Centers for Medicare & Medicaid Services (CMS) for the design of its new Long-Term Enhanced Accountable Care Organization (LEAD ACO) model, which includes features that should help primary care physicians and specialists work more closely together to deliver high-quality, coordinated care for patients.
The AMA has long maintained that value-based payment models work best when they are voluntary, led by physicians, focused on better care coordination, flexible, and designed to reduce administrative burden. Based on the information released so far, the LEAD ACO model reflects these principles.
A central feature of the LEAD model is a stronger role for specialists. Specialists are essential to the care of many patients, especially those with complex or costly conditions, yet they have had limited opportunities to participate in Medicare’s value-based care programs. The LEAD ACO model seeks to change that by allowing ACOs to formally partner with specialists to care for their patients.
“Patients are healthiest when their primary care doctors and specialists are working as a team,” said AMA CEO John Whyte, MD, MPH. “The LEAD ACO model recognizes the important role specialists play and creates new ways for them to be meaningfully involved in value-based care. By supporting team-based care, keeping participation voluntary, and offering more predictable and sustainable payments, this model has the potential to improve patient outcomes and strengthen Medicare. We appreciate CMS and the Innovation Center’s efforts and look forward to continuing to work together to make these models successful.”
Dr. Whyte recently discussed the LEAD ACO model with CMS Deputy Administrator Abe Sutton, director of the Center for Medicare and Medicaid Innovation (CMMI), and CMMI Chief Strategy Officer Gary Bacher on Moving Medicine, the AMA’s policy podcast. Listen here or download wherever you get your podcasts.
The AMA also commends CMS for proposed changes to the payment structure under the LEAD model that would reward physicians for maintaining and improving savings over time, rather than setting unrealistic spending targets that can penalize practices despite strong performance. Current benchmark-setting rules in some ACO models have discouraged physician participation or pushed practices out of the program. The LEAD model is expected to address many of these concerns.
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The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care. The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care.
