ACCESS Model: Transforming Chronic Care for Medicare Beneficiaries
The Centers for Medicare & Medicaid Services (CMS) Innovation Center has launched the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) model. This voluntary payment initiative aims to enhance healthcare outcomes for Medicare beneficiaries with chronic conditions through technology-enhanced care. The 10-year program will begin on July 1, 2026, and targets its initial application deadline for spring 2026.
The ACCESS model plans to improve traditional fee-for-service structures by linking payments to measurable health outcomes, rather than service volume. This approach introduces flexible care options, such as telehealth, FDA-approved remote monitoring devices, digital coaching, and asynchronous care. Outcome-Aligned Payments (OAPs) allow organizations to earn full payment based on predefined targets, with special considerations for rural providers to enhance service access in low-resource areas.
To participate, providers must be enrolled in Medicare Part B (excluding DMEPOS and laboratory suppliers) and comply with licensure, HIPAA, and FDA guidelines. A designated physician clinical director will ensure regulatory compliance and quality standards. Clinicians can utilize a new co-management code for care coordination, incurring no additional cost-sharing for patients.
ACCESS Model Tracks
The model offers four tracks focused on cardiovascular, metabolic, musculoskeletal, and behavioral health disorders. Each track specifies outcome measures, emphasizing issues such as blood pressure control and pain reduction. Participant payments are tied to achieving these benchmarks, concentrating on sustained health outcomes.
Patient involvement in the ACCESS model is voluntary, allowing enrollment either independently or via physician referral. Medicare beneficiaries retain standard rights, with optional waived cost-sharing under OAPs to encourage engagement.
Application and Implementation
CMS will announce requests for applications in spring 2026, with an initial deadline of April 1, 2026, for the program's start in July. Organizations wishing to join later can begin on January 1, 2027. Prospective participants should stay updated on payment details, application processes, and operational guidance as CMS provides further information.
Healthcare providers and digital health organizations considering participation must assess their ability to meet model requirements and develop patient care management strategies for selected tracks. Integrating co-management processes and electronic health record documentation is crucial for streamlining patient care updates. Rural providers, in particular, may benefit from the adjusted reimbursement rates tailored for underserved areas, emphasizing diligent preparation for the ACCESS model’s launch in July 2026.