The Centers for Medicare & Medicaid Services announced the ACCESS Model (Advancing Chronic Care with Effective, Scalable Solutions) on December 1, 2025, a voluntary, 10-year initiative aimed at improving care for Medicare beneficiaries with chronic conditions. The model reflects CMS’s continued commitment to value-based care and introduces new opportunities for health care organizations and technology innovators.
The ACCESS Model will test Outcome-Aligned Payments, a new payment option that will reward health outcomes rather than required activities. Participants will receive predictable payments for managing qualifying conditions and earn the full amount only when patients meet measurable health goals, such as lower blood pressure or reduced pain. Care can be in person, virtually, or asynchronous, whatever meets patients’ needs. The model is designed to complement traditional care by addressing gaps in chronic condition management by leveraging technology-supported care and outcome-based payment structures.
Key Dates and Participation Requirements
Application opens January 12, 2026, with a deadline of April 1, 2026. The model launches July 1, 2026. Model participants must be Medicare Part B-enrolled organizations, excluding DMEPOS and laboratory suppliers. Organizations interested in participating should complete the ACCESS Model Interest Form and begin assessing readiness for digital health integration.
Core Features and Condition-Specific Tracks
Core features include fixed installment payments tied to meeting defined clinical benchmarks, remote monitoring, digital health tools, and virtual care options as core components. Condition-specific tracks focus on cardiometabolic, cardio-kidney-metabolic, musculoskeletal, and behavioral health conditions. Participants must manage all conditions within a given track and support patient-centered care.
Implications for Providers
Participation requires meaningful changes across operations and clinical practices. Providers must review infrastructure to determine whether current systems can handle remote monitoring and deliver accurate data reporting, think through workflow integration, and weigh financial risk. Outcome-based payments introduce performance risk, so organizations need a clear strategy to meet CMS benchmarks and protect revenue. Success depends on robust data analytics, patient engagement strategies, and alignment with CMS quality metrics.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://natlawreview.com/article/cms-access-model-providers-prepare-technology-driven-value-based-care