VBC Market Landscape

Over the past 30 days, CMS has initiated a pivotal structural shift in Medicare value-based care by opening applications for the LEAD (Long-term Enhanced ACO Design) Model, which will run from 2027–2036 and introduces locked-in base years, advanced capitation, and expanded specialist risk-sharing to move beyond ACO REACH and traditional MSSP frameworks. Health systems and ACOs face new opportunities and risks as the LEAD Model positions advanced payment structures and shared risk as the backbone for scaling population health management, with technology and infrastructure transformation emerging as a critical success factor—underscored by rapid innovation such as Zynix AI’s deployment of care execution agents for ~1 million VBC patients. These developments signal escalating demands for operational readiness and data-driven care delivery as the VBC market enters a new competitive phase. For more, see Wakely’s white paper and CMS’s LEAD ACO announcement.