The Centers for Medicare & Medicaid Services (CMS) has launched an initiative aimed at improving care delivery and expanding access to services for Medicare beneficiaries through new technology-supported options.
The ACCESS Model – short for Advancing Chronic Care with Effective, Scalable Solutions – will test new approaches to coordinating care, strengthening primary care relationships, and supporting patients with chronic conditions. CMS says the model is designed to improve health outcomes through more integrated care, better communication among providers, and enhanced support for beneficiaries navigating the health system.
According to CMS, the initiative will emphasize partnerships between primary care providers, specialists, and community organizations to ensure beneficiaries receive timely, comprehensive care.
The agency describes the model as scalable and adaptable across different care settings, with the goal of identifying strategies that could be expanded more broadly across Medicare if successful.
Outcome-aligned payments
A key feature of the model is a new payment structure called “outcome‑aligned payments.” Instead of paying for specific services, CMS will tie recurring payments to measurable improvements in patients’ health, such as lower blood pressure or reduced HbA1c levels.
The agency says the approach is intended to give clinicians more flexibility to use digital tools, remote monitoring, and other technology‑enabled methods that may help patients manage chronic conditions more effectively.
ACCESS organizations are expected to offer integrated care that may include consultations, lifestyle and behavioral support, therapy, counseling, patient education, medication management, diagnostic testing, and the use or monitoring of FDA‑authorized devices or software. Care may be delivered in person, virtually, asynchronously, or through other technology‑enabled methods.
Tech component
In a December 2025 blog post, CMS highlighted a wide range of technology‑supported care tools designed to help clinicians manage chronic conditions more effectively. The agency points to digital health tools such as connected devices, remote monitoring technologies, and software that support ongoing patient engagement and track measures like blood pressure, HbA1c, and weight.
CMS also emphasizes technology‑enabled care models – including virtual visits, asynchronous communication, and digital platforms that allow clinicians to monitor patients between appointments.
“ACCESS is designed to nurture a robust ecosystem of technology-enabled care organizations and the tools that power them – including artificial intelligence diagnostics that identify people with conditions that might benefit from ACCESS services, devices that monitor biomarkers, and software that streamlines key workflows,” said CMS.
Participation
Participating organizations must be enrolled in Medicare Part B, meet state licensure and HIPAA requirements, and comply with FDA rules or enforcement discretion. Each organization must designate a physician clinical director responsible for clinical oversight and compliance.
CMS will monitor performance and publicly report aggregated, risk‑adjusted results, making transparency and data integrity central expectations for participating organizations.
Primary care providers and referring clinicians can send patients to ACCESS organizations and will receive electronic updates on patient progress. They may also bill a new co‑management payment for reviewing updates and coordinating care.
The model includes four clinical tracks – early cardio‑kidney‑metabolic conditions, cardio‑kidney‑metabolic conditions, musculoskeletal pain, and behavioral health conditions – with condition‑specific outcome measures informed by clinical guidelines. The majority of tracks include a year of care followed by a choice to continue at a lower cost for a period of time, and rural patients will receive a fixed adjustment to encourage access in underserved locations.
CMS will base payments on the overall share of patients meeting outcome targets and will publish risk‑adjusted results. Patients enroll voluntarily, retain all existing Medicare rights and benefits, and will have access to a CMS‑maintained directory of participating organizations and their reported outcomes.
AMA CEO John Whyte, MD, MPH, called ACCESS “an important step toward bringing new, effective digital health tools into everyday care for Medicare patients,” adding that the model could give clinicians more flexibility and strengthen care teams.
“For too long, outdated payment barriers have made it difficult for physicians to use new tools that can improve care for common chronic conditions,” Dr Whyte said in an AMA statement on the program. “This new model has the potential to give clinicians more flexibility, strengthen care teams, and — most importantly — help patients live healthier lives.”
Compliance takeaways
For compliance professionals, the model introduces new participation requirements, payment structures, and oversight expectations.
Organizations must ensure Medicare Part B enrollment, state licensure, HIPAA compliance, and adherence to FDA‑related obligations, while the requirement to appoint a physician clinical director adds a formal oversight role.
Importantly, the shift to outcome‑based payments means organizations must maintain accurate and comprehensive reporting, documentation, and data quality. The CMS plan to publicly report risk‑adjusted outcomes underscores the importance of transparency and accountability as the model moves forward, so organizations should anticipate heightened scrutiny.