Three Takeaways from the 2026 Health Care Value Week Conference
Coral attended the 2026 Health Care Value Week conference hosted by Accountable for Health, where CMS leadership and industry stakeholders discussed priorities shaping the next phase of value-based care. Across sessions, speakers returned to a few consistent themes: the central role of CMMI models, particularly the upcoming Long–term Enhanced ACO Design (LEAD) Model, he administration’s emphasis on addressing fraud, waste, and abuse (FWA), and the growing importance of technology and interoperability in enabling accountable care.
1. The LEAD Model is Imminent and Positioned as a Core CMMI Initiative
CMS leadership repeatedly highlighted the LEAD model as a central component of the administration’s broader prevention agenda. CMMI Director Abe Sutton indicated that the Request for Applications (RFA) for LEAD is expected within the next two weeks.
Director Sutton emphasized that CMS intends for the model to offer multiple opportunities to join over time and that organizations should not feel pressure to participate before they are ready to take on the associated level of risk. CMS leadership also acknowledged that current models may not be engaging organizations in the lower half of quality performance, suggesting that alternative participation pathways may be needed to bring more providers into value-based arrangements.
Panelists noted that longer-term models with downside risk, such as the proposed ten-year structure for LEAD, can enable organizations to rethink traditional assumptions about the time and place of care. Speakers also highlighted excitement that the model may incorporate specialist management, which could expand the scope of accountable care beyond primary care-centric approaches.
2. Fraud, Waste, and Abuse Remain a Major CMS Priority
FWA was another theme emphasized throughout the sessions. CMS Administrator Mehmet Oz reiterated that addressing program integrity is a key priority for the agency.
Recent actions cited by CMS include a six-month moratorium on new durable medical equipment (DME) suppliers, which Administrator Oz described as part of broader efforts to protect Medicare and other federal programs from inappropriate billing.
During the conference, Oz was also asked about pending litigation from certain skin substitute manufacturers challenging recent CMS payment reforms. He expressed confidence in the agency’s position and indicated that ACOs should not expect disruptions to their operations as the litigation moves forward.
3. Technology and Interoperability are Key Enablers of Value-Based Care
Technology, particularly artificial intelligence (AI), was another recurring topic across sessions. Speakers discussed a range of emerging applications, many focused on operational efficiencies such as automating medical documentation, supporting coding and revenue cycle functions, and analyzing patient records to identify quality gaps or screening opportunities.
Conference speaker Seema Verma, CMS Administrator from 2017 to 2021 and current Executive Vice President and General Manager of Oracle Health and Life Sciences, emphasized that the impact of these tools depends heavily on access to real-time information and interoperability across systems. Panelists noted that without timely data exchange, value-based care remains difficult to operationalize.
CMS pointed to the ACCESS model as an example of how technology and interoperability could expand participation in value-based care. Speakers noted that the model may also help improve access to care, particularly in rural communities, and could serve as an entry point for providers who are not currently participating in value-based arrangements.
Looking Ahead
Beyond specific model announcements, CMS leadership signaled a broader shift in how new value-based care models may be designed. Officials indicated that CMMI is moving toward more conservative model structures designed to generate savings in mid-case scenarios, not only under high-performance assumptions. This approach is intended to improve model stability and reduce the need for early redesigns.
At the same time, CMS suggested that mandatory models remain part of the agency’s portfolio. During discussions of the LEAD model, leadership encouraged engagement with the CMS Administered Risk Arrangements (CARA) component, noting that data generated through CARA may inform a future mandatory model.
Taken together, these signals suggest that organizations participating in value-based care will need to prepare for models that place greater emphasis on sustainable financial performance, stronger data capabilities, and earlier engagement with new participation pathways.
Coral works with providers, payers, and accountable care organizations to evaluate emerging CMMI opportunities, assess readiness for new risk models, and design strategies that align clinical, financial, and technology capabilities with evolving federal policy. If your organization is evaluating participation in emerging CMMI models or preparing for new value-based care requirements, connect with our team.