In this informational discussion, speakers from the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) provided an overview of the Long-term Enhanced ACO Design (LEAD) Model and opportunities for state participation. LEAD includes a novel Medicare-Medicaid integration component that has not been tested in previous CMS ACO models and programs. Under this component, ACOs will be able to partner with plans and states to offer a more comprehensive, integrated approach to serving full-benefit dually eligible individuals with Original Medicare. LEAD aims to better align incentives by allowing states to share in Medicare savings generated through improved coordination, with explicit guardrails to prevent cost shifting from Medicare to Medicaid.
Helping states develop integrated programs for individuals who are dually eligible for Medicare and Medicaid