Medicare ACCESS Model: Transforming Chronic Care with Technology
The Centers for Medicare & Medicaid Services (CMS) is launching the Advancing Chronic Care with Effective Scalable Solutions (ACCESS) model to enhance Medicare services by leveraging technology-enabled care. This program aims to test a new payment approach that empowers digital health tools, such as virtual consultations and remote patient monitoring, to improve outcomes in managing chronic conditions.
The initiative, set to run for a decade, targets conditions prevalent among Medicare beneficiaries, including hypertension, diabetes, chronic pain, and depression. Historically, Medicare's fee-for-service model lacked flexibility for technology-supported care, but the ACCESS model seeks to address this by linking payments to measurable health outcomes, establishing a framework known as Outcome-Aligned Payments (OAPs).
Participants in the ACCESS program will receive recurring payments based on their management of qualifying conditions, contingent on achieving specific health improvements, according to CMS. Chris Dawe, President of Health Services at Curana, remarked that this program steps toward integrating a comprehensive primary care model that emphasizes both on-site and virtual services, encompassing behavioral health and advanced illness management.
Senior living operators are encouraged to adopt value-based care strategies and leverage technology for improved care coordination and revenue management. ACCESS underscores the importance of a technology-focused approach, prompting providers to establish robust digital infrastructures. Will Sellheim of ATI Advisory stresses the necessity of electronic health record systems with APIs for seamless data integration, enabling more effective health status monitoring.
The program promotes the use of remote monitoring and telehealth solutions to manage chronic conditions between in-office visits. This reflects a broader shift in senior living toward embracing innovative technologies to enhance service delivery. ACCESS provides senior living providers an opportunity to boost clinical capabilities through advanced technology platforms, beneficial for assisted living and memory care facilities.
BMO Managing Director Imran Javaid emphasizes the financial benefits of ACCESS, pointing to a reduced risk profile and incremental revenue for meeting CMS benchmarks. Outcome-driven care positions senior living operators advantageously within the ACCESS framework due to their existing daily care practices.
The success of ACCESS will hinge on forming strategic partnerships with care providers and ensuring compliance with program requirements. While some industry experts view the model's financial risk as limited, its viability in enhancing revenue remains to be seen. Nonetheless, the trend toward utilizing remote patient monitoring and other technologies could significantly transform senior living operations. Establishing relevant partnerships and implementing technology measures will be crucial for senior living operators to maximize the benefits of the ACCESS model.