CMS Launches ACCESS Model to Advance Technology-Supported Chronic Care in Medicare FFS

The Centers for Medicare & Medicaid Services (CMS) is launching the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model, a new 10-year national test starting July 1, 2026, aimed at improving chronic disease management through technology-supported care under Medicare fee-for-service (FFS). ACCESS is a voluntary, outcome-aligned payment (OAP) program targeting Medicare beneficiaries with specified chronic conditions, offering a new payment methodology focusing on patient health outcomes rather than individual services delivered. Organizations will be able to apply to participate in ACCESS starting January 2026, with applications accepted through January 2033 and multiple entry points across the decade. Initial participation applications for the first performance period must be submitted by March 20, 2026. The model includes four clinical tracks addressing common chronic diseases, with the option for organizations to participate in multiple tracks. Medicare beneficiaries can enroll directly with participating organizations or through clinician referrals and may register for multiple tracks. When enrolled in multiple tracks with the same provider, CMS applies a payment discount reflecting operational efficiencies. Eligible participants must be Medicare Part B providers or suppliers (excluding certain DME and lab suppliers), appoint a physician clinical director, and comply with federal and state regulatory standards, including HIPAA and FDA requirements when applicable. ACCESS introduces a payment model that departs from traditional fee-for-service by issuing recurring outcome-aligned payments based on specific patient condition improvements. For example, successful blood pressure reduction in hypertensive patients would trigger full payment. Additionally, primary care and referring clinicians can bill a co-management payment for care coordination activities without beneficiary cost sharing. The program features an optional continuation period with reduced payments reflecting stabilized patient care, except for conditions like musculoskeletal pain, which targets resolution during the initial care phase. CMS provides a patient incentive safe harbor to waive beneficiary cost sharing on OAPs as part of engagement strategies. CMS will maintain a public directory listing participating providers, treated conditions, and clinical outcomes, with monitoring and potential disenrollment for entities failing quality or safety standards. The ACCESS Tools Directory will offer participants access to technology products and services to support care coordination, with vendors optionally listing discounts or offers adhering to federal inducement rules. The ACCESS Model complements existing Medicare Shared Savings Programs (MSSP) and Accountable Care Organizations (ACOs), allowing ACOs to integrate technology-enabled chronic care management. While initial years will exclude ACCESS-related payments from ACO benchmarks, expenditures will be included starting in 2028. ACCESS is not classified as an Advanced Alternative Payment Model, nor will services under it contribute to Merit-Based Incentive Payment System reporting requirements. CMS will provide further billing guidance, including specific co-management codes and modifiers, in 2026. The initiative represents CMS's effort to incentivize technology-driven, outcomes-focused chronic disease care within Medicare FFS, emphasizing quality improvement, care coordination, and scalable solutions during a decade-long voluntary program.