Specialty Payment Models

LEAD applicants are entering a near-term decision window: acceptance letters are out, Participant TIN lists are due to CMS in early August, and organizations that also applied to MSSP must choose a path before final rules and the LEAD financial methodology are released later this summer—raising immediate issues around attribution, downside-risk exposure, and reserve/corridor strategy for ACOs (Wakely). Separately, CMS under the Trump administration is proposing higher Medicare dialysis payments and quality rule changes, signaling continued movement in specialty payment policy where ESRD providers, nephrology groups, and ACOs will need to reassess margin, quality-measure performance, and alignment incentives (MyChesCo.