LEAD Model + EOM PY2026 rosters — 3-leg (DS + VBC + PI) competitor check in the adjacent CMS venues

The question

"Check the LEAD Model and EOM PY2026 accepted-applicant lists for the same 3-leg (DS + VBC + PI) patient-data-sovereignty rubric." These are the two adjacent CMS/CMMI innovation venues (beyond ACCESS) where a patient-data-sovereignty competitor might apply instead. The rubric (from the parent ACCESS roster brief) scores each org on three legs: DS = patient-as-data-source-of-truth / patient-as-data-principal; VBC = a value-based contract with a payer; PI = patient cash payouts from the savings share. A 3/3 is a live patient-data-sovereignty competitor. Goal: close the blind spot that a competitor picked LEAD or EOM rather than ACCESS.

What we already know (from the vault)

• [[2026-05-18-cms-access-approved-applicant-roster]] — the parent brief. Verdict: no 3/3 competitor in the ACCESS Model 150+ roster; every named participant scored at most 1/3 (VBC leg present, DS and PI absent). Its own Open Follow-ups line explicitly seeded this brief: "Check the LEAD Model and EOM PY2026 accepted-applicant lists for the same 3-leg rubric." This brief applies the identical rubric and methodology (enumerate named participants across trade press, score each on DS/VBC/PI, flag coverage gaps).
• [[2026-05-11-patient-data-sovereignty-competitor-scan]] — origin of the DS + VBC + PI rubric. 12 candidates scored, none 3/3; the "clean white space" conclusion.
• [[2026-05-10-healthcare-outcome-procurement-pioneering-provider]] — the parent thesis doc; it names LEAD directly ("ACO REACH sunset Dec 2026, replaced by LEAD"; "LEAD Model Jan 1 2027") as one of the CMS innovation venues that could host the bet.
• [[2026-06-27-patient-data-sovereignty-competitor-pivot-v2]] — most recent competitor state (June 27): the three closest patient-data-sovereignty competitors all pivoted away. The field is thinning, not filling — context for reading a "no 3/3" result as a durable white space rather than a snapshot.

What the web says

• LEAD = Long-term Enhanced ACO Design Model. A voluntary 10-year CMMI ACO model, successor to ACO REACH (which sunsets Dec 31 2026). It launches Jan 1 2027 and is designed to pull in smaller, rural and high-needs-serving clinicians via predictable benchmarks and flexible payments. Applications opened March 2026; CMS has not published an accepted-applicant roster. (Coral Health Advisors LEAD explainer, CMS Innovation Models) — hard coverage gap: there is no LEAD roster to scan yet.
• LEAD is a total-cost-of-care ACO model — value-based by design (VBC leg present for any eventual participant), but its architecture rewards the ACO/provider for savings. It contains no patient-as-data-principal mechanism (DS) and no patient cash-from-savings mechanism (PI). A 3/3 could only arise if a sovereignty-positioned org joined as a downstream risk-taker layering its own DS/PI product on top — none is announced.
• EOM = Enhancing Oncology Model. CMMI's 5-year value-based oncology model, successor to the Oncology Care Model (OCM). PY2026 is the ongoing performance period (PP6); practices decided by Nov 30 whether to continue for 2026. Participation figures: ~44 practices at launch; CMS's current count is 28 physician group practices + 1 commercial payer, rising to ~38 practices + 2 payers as of Sept 2025; a second cohort (July 2025) added 7 practices — ~3,000 practitioners, ~500 sites, 33 states + DC. (CMS EOM, AJMC)
• Named EOM participants (aggregated across AJMC / GlobeNewswire coverage): Tennessee Oncology (OneOncology), Texas Oncology (US Oncology Network), Northwest Medical Specialties, Rocky Mountain Cancer Centers, Minnesota Oncology, West Clinic, The Cancer and Hematology Centers of Western Michigan, and American Oncology Network (AON) practices (~10% of the EOM population). Parent networks: OneOncology, US Oncology Network, American Oncology Network. (AJMC, AON / GlobeNewswire)
• EOM rubric verdict — every named participant ≤ 1/3. EOM is two-sided-risk value-based oncology (VBC = YES). Its Monthly Enhanced Oncology Services (MEOS) payments and any performance-based payment flow to the practice, not to the patient — so PI = NO. Participants are oncology provider groups managing data in standard EHRs, with no patient-as-data-principal restructuring — DS = NO. No named EOM participant reaches even 2/3; none is a 3/3.

Convergences and contradictions

• Convergence with ACCESS: all three adjacent venues (ACCESS, EOM, LEAD) are provider/ACO value-based models. VBC is present by model design, but none of the three ships a DS or PI mechanism. The white space is structural, not incidental — these CMS models pay the provider/ACO for savings, not the patient, and none makes the patient the data principal.
• Contradiction / surprise in the question's framing: the prompt assumes a LEAD "accepted-applicant list" exists to scan. It does not yet. LEAD applications opened March 2026 and the model launches Jan 1 2027; CMS has published no roster. So the LEAD leg cannot be answered on the same footing as EOM — it is deferred, not cleared.
• Retrieval friction: cms.gov and AJMC returned HTTP 403 to automated fetch on every attempt; participant names came from search-index snippets, not full-page reads. The EOM named subset (~8-10 practices + 3 networks) is a partial enumeration of the ~28-38 total; the unnamed remainder and the 2 commercial payers were not individually retrieved.

Synthesis for RDCO

The scan surfaces no 3/3 (DS + VBC + PI) competitor in either adjacent venue, and — more usefully — explains why one is structurally unlikely there. EOM and LEAD are both provider-side value-based models: the economic reward for reducing total cost of care accrues to the oncology practice or the ACO, and the patient is a beneficiary attributed to that entity, not a data principal or a cash counterparty. That means a participant can max the VBC leg while remaining permanently at 1/3 — exactly the pattern the ACCESS roster showed. A patient-data-sovereignty competitor would have to bolt DS and PI onto the model from the outside (as a downstream risk-taker or a patient-incentive product layered over the contract), and nothing in the enumerated EOM roster does that. The named EOM participants — Tennessee Oncology, Texas Oncology, the OneOncology / US Oncology / American Oncology networks — are large multi-site oncology groups executing value-based cancer care, the direct analog of the ACCESS VBC-enabler cluster. Same shape, same 1/3 ceiling.

The residual blind spot is honest and specific. First, LEAD has no published roster, so that leg is a genuine deferral: the check must be re-run when CMS releases the accepted-applicant list ahead of the Jan 1 2027 launch (plausibly late 2026). By model design LEAD cannot host a 3/3 on its own terms, but the roster is where a sovereignty-positioned downstream partner would first become visible, so it is worth monitoring rather than assuming clear. Second, on the EOM side the enumeration is partial — roughly 8-10 of ~28-38 practices were named, plus 2 commercial payers that no source named. The payers are the more interesting gap: a payer participant (versus a provider practice) is the participant type most capable of layering a patient-incentive or patient-data-sharing product, and those two are exactly the entities not individually retrieved.

Net for the patient-data-sovereignty bet: the competitive white space survives this adjacent-venue check, consistent with the ACCESS roster and the June 27 close-out finding that the closest competitors have been pivoting away. No CMMI value-based venue examined — ACCESS, EOM, or (by design) LEAD — currently rewards the patient as data principal or pays the patient cash from the savings share. That is precisely the wedge. The honest caveat is that "no 3/3 found" here rests partly on a roster that does not exist yet (LEAD) and a roster only partially enumerated (EOM), so this brief narrows the blind spot rather than closing it fully.

Open follow-ups

• Re-run the LEAD Model roster check once CMS publishes the accepted-applicant list ahead of the Jan 1 2027 launch — the roster genuinely does not exist yet, so this leg is deferred, not cleared.
• Pull the full EOM participant list via a non-403 path (Wayback snapshot of the CMS EOM page, or the data.cms.gov "Innovation Center Model Participants" dataset) to score the ~20-30 unnamed practices against the rubric.
• Single-entity check on the 2 EOM commercial payers — unnamed in all surveyed coverage, and the participant type most likely to layer a patient-incentive / patient-data-sharing product (the participant most capable of an eventual 2/3 or 3/3).
• Watch for any ACCESS / EOM / LEAD participant that adds a patient-cash-from-savings or patient-data-principal layer over time (the "1/3 today upgrades toward 3/3" velocity risk already flagged for PicnicHealth ThumbPrint).

Related

• [[2026-05-18-cms-access-approved-applicant-roster]]
• [[2026-05-11-patient-data-sovereignty-competitor-scan]]
• [[2026-05-10-healthcare-outcome-procurement-pioneering-provider]]
• [[2026-06-27-patient-data-sovereignty-competitor-pivot-v2]]
• [[2026-05-10-data-sovereignty-outcome-procurement-bet-architecture]]

Sources

• [[2026-05-18-cms-access-approved-applicant-roster]] — parent brief, rubric + methodology (~/rdco-vault/06-reference/research/2026-05-18-cms-access-approved-applicant-roster.md)
• [[2026-05-11-patient-data-sovereignty-competitor-scan]] — DS+VBC+PI rubric origin (~/rdco-vault/06-reference/research/2026-05-11-patient-data-sovereignty-competitor-scan.md)
• [[2026-05-10-healthcare-outcome-procurement-pioneering-provider]] — names LEAD / ACO REACH transition (~/rdco-vault/06-reference/research/2026-05-10-healthcare-outcome-procurement-pioneering-provider.md)
• [[2026-06-27-patient-data-sovereignty-competitor-pivot-v2]] — latest competitor state (~/rdco-vault/06-reference/research/2026-06-27-patient-data-sovereignty-competitor-pivot-v2.md)
• [[2026-05-10-data-sovereignty-outcome-procurement-bet-architecture]] — bet architecture (~/rdco-vault/01-projects/health-and-longevity/2026-05-10-data-sovereignty-outcome-procurement-bet-architecture.md)
• CMS Innovation Models — LEAD listed; roster not yet published (WebFetch 403, indexed snippet used)
• Coral Health Advisors — LEAD (Long-term Enhanced ACO Design) explainer — LEAD launches Jan 1 2027, applications opened March 2026
• CMS — Enhancing Oncology Model (EOM) — PY2026 / PP6, participant counts (WebFetch 403, indexed snippet used)
• AJMC — Final Tally Lists 44 Practices in EOM — named practices, two-sided-risk structure (WebFetch 403, indexed snippet used)
• AJMC — EOM Attracts Key Practices / Leaders from the OCM — Tennessee Oncology, Texas Oncology, Northwest Medical Specialties
• American Oncology Network / GlobeNewswire — EOM first performance period — AON ~10% of EOM population