CMS Launches ACCESS Payment Model to Enhance Tech-Enabled Care for Medicare Chronic Conditions

The Centers for Medicare & Medicaid Services (CMS) has introduced a new payment model called ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) aimed at improving access to technology-based care for Medicare beneficiaries with chronic conditions, including behavioral health issues like anxiety and depression. Traditionally, Medicare's fee-for-service structure did not reimburse many digital health services, but ACCESS shifts payment to a value-based model that rewards outcomes rather than individual services. Under ACCESS, providers receive recurring payments contingent on meeting patient health outcome targets defined by CMS, promoting accountability and incentivizing effective chronic disease management. ACCESS offers four clinical tracks with guideline-informed, condition-specific measures that providers must meet to receive payments. This model supports integrating technology into care coordination efforts, enabling continuous support of patients even outside traditional office visits. CMS highlights that the payment structure balances accessibility with accountability by setting minimum outcome thresholds that increase annually. This initiative aligns with CMS’s broader strategy of advancing value-based care and expanding digital health adoption within Medicare. It follows earlier efforts, such as the Innovation in Behavioral Health (IBH) model, which focused on integrating physical and behavioral health services through value-based approaches. ACCESS reflects ongoing regulatory interest in leveraging technology and outcome-aligned payments to enhance care for chronic conditions in the Medicare population. By fostering provider collaboration with technology-enabled care partners and shifting Medicare reimbursements toward outcomes, the ACCESS model aims to streamline care delivery and improve patient results for a significant segment of the Medicare population managing chronic and behavioral health conditions. These developments are key for payer and provider stakeholders navigating evolving Medicare reimbursement frameworks and digital health integration in the United States.