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# UPDATE: CMS's ACO REACH savings and evaluation numbers still disagree, LEAD decision pending
- URL: https://members.americanhealthintel.com/2026-08-03-serviceline/
- Published: 2026-08-06T14:42:20.000Z
- Updated: 2026-08-06T14:42:20.000Z
- Description: Plus: CMS details LEAD Model's capitated payment menu and 10-year risk commitment. The day's rules, money, and enforcement, sourced and tiered below.
- Author: American Health Intel

Plus: CMS details LEAD Model's capitated payment menu and 10-year risk commitment. The day's rules, money, and enforcement, sourced and tiered below.

| American Health Intel Rules · Money · Medicine · Decoded daily The Service Line Monday, August 3, 2026 UPDATE: CMS's ACO REACH savings and evaluation numbers still disagree, LEAD decision pending Plus: CMS details LEAD Model's capitated payment menu and 10-year risk commitment. The day's rules, money, and enforcement, sourced and tiered below. ![](https://americanhealthintel.com/email/pulse-divider.png) Report Confidence: Medium CMS's own scorecard on the accountable care model it is retiring next year tells two different stories at once: record settlement savings, but its independent evaluator says Medicare spending is still going up, not down. The 2024 settlement credits ACO REACH with $988.3M in net savings. CMS's third evaluation report says net spending rose 0.8% in 2023, narrowing to 0.2% in 2024\. No public list of accepted LEAD Model participants exists yet. Why it matters CMS's own numbers on its flagship accountable care model contradict each other right as ACOs decide whether to sign a ten-year commitment to its successor; watch for whether CMS ever reconciles the two methodologies. Sources: [Fiercehealthcare](https://www.fiercehealthcare.com/regulatory/aco-reach-participants-generated-nearly-1b-2024-savings-cms?ref=members.americanhealthintel.com) · [CMS](https://www.cms.gov/priorities/innovation/data-and-reports/2026/aco-reach-3rd-eval-report?ref=members.americanhealthintel.com) · [CMS](https://www.cms.gov/priorities/innovation/innovation-models/lead?ref=members.americanhealthintel.com) Rule Confidence: High Medicare just published the actual paycheck mechanics for the accountable care model replacing ACO REACH in 2027, a menu of monthly capitated payments instead of a savings check once a year. ACOs choose Primary Care Capitation or, at full risk, Total Care Capitation covering all Part A and B spending. An upfront cash advance option must be repaid in full. The commitment runs 10 years, double MSSP's cycle. Why it matters Medicare is replacing an annual savings check with monthly capitated payments for accountable care organizations, a structural shift that locks participants in for twice as long as the current model. Sources: [CMS](https://www.cms.gov/priorities/innovation/files/lead-payment-fs.pdf?ref=members.americanhealthintel.com) · [CMS](https://www.cms.gov/priorities/innovation/lead-model-frequently-asked-questions?ref=members.americanhealthintel.com) Also today California fines Carbon Health $4.5M over corporate practice of medicine [Read](https://americanhealthintel.com/editions/2026-08-03-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#carbon-health-cpom-settlement-california) Pearl Health raises $110M to expand AI risk platform for primary care [Read](https://americanhealthintel.com/editions/2026-08-03-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#pearl-health-110m-raise-a16z) Employers now fund majority of direct primary care memberships [Read](https://americanhealthintel.com/editions/2026-08-03-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#dpc-employer-funded-majority-2026) 404Records$31.7BEnforcement17Deadlines117Rules [Read this issue + the trackers](https://americanhealthintel.com/editions/2026-08-03-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) Pick your field on the site and every story tells you what it means for you. Reply to this email and tell us what you want covered. We read everything. We show our work. We score our own calls. [Track record](https://americanhealthintel.com/ledger/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [Calendar](https://americanhealthintel.com/calendar/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [Enforcement](https://americanhealthintel.com/enforcement/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [X](https://x.com/amhealthintel?ref=members.americanhealthintel.com) · [LinkedIn](https://www.linkedin.com/company/american-health-intel?ref=members.americanhealthintel.com) News and analysis, not legal, medical, coding, or investment advice.You subscribed at americanhealthintel.com · [Unsubscribe](%%{unsubscribe%5Furl}%%) |
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