What's Happening?
The Centers for Medicare & Medicaid Services (CMS) Innovation Center has introduced the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) model. This 10-year voluntary payment model aims to expand access to technology-supported care for Medicare beneficiaries
with chronic conditions. The model will begin on July 1, 2026, with applications opening in spring 2026. ACCESS focuses on measurable health improvements rather than the volume of services, complementing traditional fee-for-service care. It includes outcome-aligned payments (OAPs) for organizations managing chronic conditions using technology-enabled services like telehealth and remote monitoring. CMS will provide increased reimbursement to rural providers to enhance access in underserved areas.
Why It's Important?
The ACCESS model addresses a significant gap in traditional Medicare fee-for-service by shifting financial incentives towards measurable health outcomes. This approach encourages modern care delivery beyond clinic walls, potentially improving prevention, care management, and patient choice. By offering increased reimbursement to rural providers, the model aims to reduce disparities in healthcare access. The transparency in reporting risk-adjusted outcomes will help patients and clinicians make informed decisions. The model's focus on technology-enabled services could lead to more efficient and effective management of chronic conditions, benefiting both patients and healthcare providers.
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 submit applications by April 1, 2026, for consideration. CMS will provide detailed FAQs and technical guidance to support prospective participants. Healthcare providers and digital health organizations need to assess their readiness to meet participation requirements and manage patients across specified tracks. Rural providers should evaluate opportunities enabled by rural payment adjustments. All participants must monitor the ACCESS RFA for payment rates, thresholds, and operational details.
Beyond the Headlines
The ACCESS model could lead to long-term shifts in how chronic diseases are managed, emphasizing technology-enabled care. This approach may drive innovation in digital health solutions and remote monitoring technologies. The model's focus on outcome-based payments could influence broader healthcare policy, encouraging similar initiatives in other areas of care. By reducing beneficiary cost-sharing, the model aims to increase patient engagement and adherence to treatment plans, potentially improving overall health outcomes.
