CMS Announces ACCESS (Advancing Chronic Care With Effective, Scalable Solutions) Model

Key Takeaways:

• The ACCESS Model¹ tests an outcome-aligned payment (OAP) approach designed to give people with Original Medicare new options to improve their health and prevent and manage chronic disease with technology-supported care.
• The voluntary model focuses on common conditions, including high blood pressure, kidney disease, diabetes, chronic musculosketal pain, depression, and anxiety. These conditions impact roughly 2/3 of people with Medicare.
• CMS will begin accepting applications on a rolling basis in January with an initial application deadline of March 20, 2026. The first ACCESS cohort will launch July 1, 2026.

Model Structure

Original Medicare pays for a defined set of activities that do not typically align with the way technology-supported care is delivered.

The ACCESS Model will test OAPs, a payment option for Medicare-enrolled care organizations. Participating organizations will receive recurring payments for managing patients' qualifying conditions, with full payment tied to achieving measurable health outcomes tied to each person's baseline. Payments and expected outcomes will be different for each condition/track and determined by the overall share of an organization's patients meeting targets.

ACCESS care organizations are expected to offer integrated, technology-supported care that can be in-person, virtual, asynchronous, or technology-enabled methods as clinically appropriate, that may include:

• Clinician consultations
• Lifestyle and behavioral support (nutrition, exercise, smoking cessation)
• Therapy and counseling
• Patient education and care coordination
• Medication management
• Ordering and interpreting diagnostic tests and imaging
• Use or monitoring of Food and Drug Administration (FDA)-authorized devices or software

Model participants must enroll in Medicare Part B as providers or suppliers and meet state licensure requirements, but the Model is designed to operate alongside traditional care, so patients will need to voluntarily enroll or be referred by their provider.

ACCESS will initially include four clinical tracks focusing on common chronic conditions, including:

• Early Cardio-Kidney Metabolic (eCKM): Includes hypertension, dyslipidemia, obesity/overweight with central adiposity, and prediabetes. Providers can track blood pressure, lipid panel, weight/BMI, and other lifestyle adherence via connected devices.
• Cardio-Kidney Metabolic (CKM): Includes diabetes, chronic kidney disease, or atherosclerotic cardiovascular disease. Providers may monitor HbA1c, blood pressure, lipids, and weight through lab values and device feeds, plus medication adherence.
• Musculoskeletal (MSK): Includes chronic musculoskeletal pain. Providers may measure clinically meaningful improvements such as opioid-sparing outcomes over time.
• Behavioral Health (BH): Includes depression or anxiety. Providers may monitor treatment adherence, care coordination, and symptom reduction relative to baseline.

Who Can Participate?

ACCESS participants must be Medicare Part B–enrolled organizations (excluding Durable Medical Equipment, Prosthetics, Orthotics, and Supplies and laboratory suppliers) and designate a Medicare-enrolled Clinical Director to oversee care quality and compliance. Organizations not enrolled in Medicare Part B must enroll to participate in ACCESS. Medicare Advantage plans are not eligible but may provide similar services.

Model Timing

CMS will begin accepting rolling applications for the 10-year voluntary model in January, with an initial application deadline of March 20, 2026. The first cohort will launch July 1, 2026.

While a request for applications is not yet available, an ACCESS Model Interest Form can be completed to be notified when the application becomes available.

Unknowns

CMS has not yet clarified payment amounts and methodologies, nor has it clarified risk methodologies or quality metrics. These details will be important for potential applicants and will potentially temper—or turbocharge—potential interest.

Quick Take

This model is a continuation of CMMI's focus on coupling novel technologies with Medicare payment flexibility by testing OAPs that tie payments that depend on measurable improvements in patient health. This will allow Medicare fee-for-service to cover items and services that are not purely "medical" in nature that can help prevent decline rather than merely treating a symptom of a disease or chronic condition. In this sense, ACCESS provides fee-for-service with a boost that allows providers and provider-led efforts to better compete with existing Medicare Advantage flexibilities.

The model is also a continuation of the team-based approach seen in the GUIDE Model, which provides care coordination and caregiver support for people with dementia.²

With more than ten thousand baby boomers aging into Medicare each day, this represents a natural and needed evolution of the Medicare benefit.

Footnotes

1 https://www.cms.gov/priorities/innovation/innovation-models/access

2 https://www.cms.gov/priorities/innovation/innovation-models/guide

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