CMS Unveils ACCESS Model for Technology-Driven Chronic Care Management

On December 1, the Centers for Medicare & Medicaid Services (CMS) announced the Advancing Chronic Care with Effective, Scalable Solutions Model (ACCESS), a decade-long voluntary alternative payment model (APM) designed to improve care for chronic conditions through technology-supported interventions. ACCESS targets chronic conditions affecting two-thirds of Medicare beneficiaries and offers recurring, outcome-based payments to participating organizations, though many specifics such as payment amounts and risk-sharing requirements are yet to be finalized. The model, developed by the CMS Innovation Center, emphasizes evidence-based preventive care and care management, aiming to empower patients and enhance clinical collaboration. Scheduled to run from July 2026 through June 2037, ACCESS will begin accepting applications in January 2026 with ongoing submissions for subsequent periods. Participation requires enrollment in Medicare Part B, adherence to standard Medicare participation standards, and assignment of a physician clinical director responsible for care quality. ACCESS participants will deliver technology-enabled care, including telehealth therapies, digital nutrition coaching, or wearable device monitoring, with payments contingent on achieving measurable patient outcomes. The model integrates with traditional care by supporting information sharing with primary care and specialists, incentivizing clinicians through a new co-management billing code for care coordination activities valued up to approximately $100 per beneficiary annually. Initial focus areas include early and established cardio-kidney-metabolic conditions, musculoskeletal disorders, and behavioral health, with room to expand. Data reporting requirements include clinical metrics and patient-reported outcomes. Medicare beneficiaries may enroll directly or via clinician referral, with CMS maintaining a public directory of ACCESS providers to assist with informed selection based on treated conditions and risk-adjusted outcomes. ACCESS aims to open new revenue streams for healthcare providers, technology firms, and population health organizations currently undercompensated for chronic condition management in fee-for-service settings. Its voluntary structure may limit participation compared to recent mandatory Innovation Center models but could attract providers across different risk and payment arrangements, supporting broader adoption of value-based care technologies. Overall, ACCESS represents a strategic effort by CMS to align financial incentives with improved chronic disease management through technology and care coordination. Key details pending publication will determine its full impact on provider behavior, market participation, and Medicare patients' health outcomes over the coming decade.