Help you stay well.
Your care team can put more attention on screenings, preventive care, and chronic-condition support.
For patients and families
Accountable care helps your clinicians work together around your health, your goals, and the care you receive between visits. It is designed to make prevention, follow-up, and support easier to reach.
Original Medicare stays in place · Your covered benefits stay in place · You keep your freedom to choose Medicare providers
Accountable care, in plain language
An Accountable Care Organization, or ACO, is a group of doctors and other care organizations that works together to improve the quality, coordination, and overall cost of care for people with Medicare.
Your care team can put more attention on screenings, preventive care, and chronic-condition support.
Your clinicians can share permitted information and coordinate after referrals, hospital stays, and medication changes.
A clearer care plan can show who is responsible for the next step and whether it was completed.
What stays yours
Being aligned with an ACO does not replace your Medicare benefits or turn Original Medicare into a restricted network.
ACO alignment changes how participating clinicians coordinate and accept accountability. It does not replace Original Medicare.
You remain free to seek medically necessary care from any Medicare-enrolled provider, even if that provider is not part of the ACO.
LEAD includes a voluntary option that lets eligible people identify the practice or clinician they consider their main source of care.
Health information may be used and shared only as permitted by law, program rules, notices, agreements, and your applicable choices.
Access to care
The right setting depends on your health, preferences, location, clinician's judgment, available services, and coverage.
Your regular practice remains the center for longitudinal care, prevention, and chronic-condition management.
Appropriate services may be available at home for people whose health or mobility makes access difficult.
Coordination can help your ongoing care team understand what changed and what needs to happen next.
Your care plan may connect specialists, pharmacists, behavioral health, social supports, and caregivers.
The LEAD Model
LEAD is not only a senior-care or high-needs program. It is a CMS accountable care model for a broader range of eligible people with Original Medicare.
Eligible people may qualify for Medicare based on age or disability and receive care across many levels of need.
LEAD recognizes ESRD as a distinct category that requires focused clinical and financial design.
CMS uses defined clinical and claims-based criteria to identify this category; a patient does not need to label themselves.
Who may be eligible
This page is general information, not an eligibility determination or a notice that Sphere is currently providing care to you.
Eligible people generally have Medicare Parts A and B, with Medicare as their primary payer.
People enrolled in Medicare Advantage or another Medicare managed-care plan are not eligible for LEAD alignment under current CMS rules.
A person must live in the United States and in a county included in the participating ACO's approved service area.
CMS and the participating ACO determine alignment and eligibility. Services depend on clinical need, coverage, availability, consent, and program rules.
This website is not a clinical service, medical advice, or emergency channel. Contact your clinician for care questions. Call 911 or local emergency services for a medical emergency.
Patient-choice and LEAD descriptions are based on current CMS materials. Model features and individual eligibility can change.