What's Happening?
The CMS Innovation Center has introduced the ACCESS model, aimed at improving care for chronic disease patients through technology-supported services. Set to begin on July 1, 2026, the model will test a recurring, outcomes-tied payment system for organizations
managing chronic conditions using telehealth, remote monitoring, and digital coaching. The initiative seeks to address payment gaps in traditional Medicare fee-for-service by incentivizing measurable health outcomes rather than service volume. Participating organizations can earn full payment based on patient improvement, with increased reimbursement for rural providers to enhance access in underserved areas. The model includes four clinical tracks focusing on conditions such as hypertension, diabetes, musculoskeletal pain, and behavioral health, with specific outcome measures for each.
Why It's Important?
The ACCESS model represents a significant shift in Medicare payment structures, emphasizing outcomes over service volume. This approach could lead to improved health management for chronic disease patients, potentially reducing long-term healthcare costs. By incentivizing measurable health improvements, the model encourages providers to adopt modern care delivery methods, such as telehealth and remote monitoring, which can enhance patient engagement and care efficiency. The increased reimbursement for rural providers aims to address healthcare disparities, promoting equitable access to advanced care solutions. This initiative could set a precedent for future healthcare payment models, influencing policy and practice across the U.S. healthcare system.
What's Next?
CMS will begin accepting applications for the ACCESS model in Spring 2026, with the first performance period starting on July 1, 2026. Interested organizations must assess their readiness to meet participation requirements and manage patients across specified tracks. CMS will provide detailed guidance and FAQs to support prospective participants. As the model progresses, outcome measure thresholds will increase, challenging providers to continuously improve patient care. The success of the ACCESS model could lead to broader adoption of similar payment structures, potentially influencing Medicare policy and healthcare delivery nationwide.
