What Is the CMS ACCESS Model?
The Centers for Medicare and Medicaid Services (CMS) Innovation Center announced the ACCESS Model — Advancing Chronic Care with Effective, Scalable Solutions — in December 2025. It is a national, voluntary, 10-year initiative designed to test a new outcomes-based payment approach for technology-supported chronic care in Original Medicare.
Digital technologies are transforming care delivery, helping patients manage chronic conditions with continuous support beyond the doctor’s office. Telehealth software connects patients with providers remotely. Wearable devices track sleep, heart rate, blood sugar, and other vital functions. Apps coach people toward lifestyle changes that benefit both physical and behavioral health.
Traditional Medicare, however, has not kept pace. Medicare payment barriers have long limited access to technology-supported chronic care because many tech tools and support services are not Medicare-reimbursable. The ACCESS Model directly addresses this gap.
Who Got Selected and Why It Matters
150+ Participants Provisionally Approved
More than 150 companies and providers have received provisional approval to participate in this experimental Medicare program. They include popular mental health apps, wearable device makers, a life sciences company tied to Google, and startups that help large health systems manage heart failure patients.
This number surprised even CMS officials. The large number of applications exceeded their expectations, and the enthusiasm suggests modest payment rates and restrictions did not discourage digital health companies from applying. Most of the participants had not previously served Medicare patients.
A New Medicare Participation Pathway
The ACCESS Model creates one of the most accessible entry points for digital health organizations to directly serve Medicare. Unlike MSSP ACOs or ACO REACH entities, ACCESS Organizations are not required to assume downside financial risk. This makes it one of the most accessible Innovation Center participation pathways for digital and hybrid chronic-care companies, many of which historically operated only through subcontracting relationships.
Furthermore, CMS has taken the unprecedented step of allowing direct beneficiary enrollment, removing historical dependence on ACO alignment or claims-based attribution.
Four Chronic Condition Tracks Covered
Broad Reach Across Common Medicare Conditions
ACCESS focuses on four clinical tracks addressing many of the most common chronic conditions among Medicare beneficiaries. These tracks are:
- Early Cardio-Kidney-Metabolic (eCKM): Hypertension, dyslipidemia, obesity, and prediabetes
- Cardio-Kidney-Metabolic (CKM): Diabetes, chronic kidney disease, and atherosclerotic cardiovascular disease
- Musculoskeletal (MSK): Chronic musculoskeletal pain
- Behavioral Health (BH): Depression and anxiety
The model is broad-reaching, with an estimated two-thirds of Medicare fee-for-service beneficiaries having at least one of the targeted chronic conditions. Consequently, the potential patient impact is enormous.
Care Delivery Flexibility
Care may be provided in-person, virtually, asynchronously, or through other technology-enabled methods as clinically appropriate. This flexibility allows participants to design care pathways that best fit each patient’s circumstances.
How Outcome-Aligned Payments Work
Payments Tied to Results, Not Activities
The ACCESS Model introduces an outcome-aligned payment option that rewards results rather than required activities, enabling new ways of delivering effective technology-supported care.
ACCESS provides participating organizations with predictable, recurring payments for helping patients manage qualifying chronic conditions. Full payment depends on achieving measurable health outcomes, such as improvement or control of blood pressure for hypertension. Rather than paying for a specific set of services, the model rewards results — giving care teams flexibility to use technology and care approaches that best support each patient’s needs.
Co-Management Payments for Referring Clinicians
Primary care providers also benefit. PCPs and referring clinicians may bill a new co-management payment for documented review of patient updates and associated coordination activities, such as medication adjustments or problem list updates. This strengthens collaboration between ACCESS organizations and traditional providers. The co-management payment amounts to approximately $30 per service, plus a one-time $10 bonus for onboarding beneficiaries.
Rural Providers Get a Boost
CMS will provide increased reimbursement under the program to rural providers to promote access in underserved areas. Additionally, CMS will publicly report risk-adjusted outcomes for participating organizations to promote transparency and informed selection by patients and referring clinicians.
Deadline Extended to Welcome More Participants
The initial deadline to participate in the first ACCESS cohort was April 1, but CMMI has announced an extension to allow more organizations to join. This extension reflects strong industry interest and signals CMS’s commitment to broadening the program’s impact from the outset.
The model is slated to begin on July 1, 2026, with rolling applications continuing into 2033. Organizations that miss the first cohort can therefore still apply and join in later waves.
FDA’s TEMPO Pilot Runs in Parallel
The FDA’s Technology-Enabled Meaningful Patient Outcomes (TEMPO) pilot will work collaboratively with the ACCESS Model. Manufacturers of digital health devices that have not yet received FDA authorization can apply to TEMPO for enforcement discretion, allowing their devices to be used by ACCESS participants for covered care.
What This Means for Digital Health
A Landmark Shift in Medicare Payment
The ACCESS Model marks a significant policy turning point. ACCESS aims to remove payment barriers by aligning reimbursement with outcomes, enabling healthcare providers and suppliers to deploy scalable, technology-enabled services that complement traditional care.
The ACCESS Model reflects CMS’s continued movement toward expanding direct, outcomes-based participation opportunities for chronic-care providers, digital health organizations, and community partners.
How to Join
Organizations interested in participating should act quickly. Part B providers should assess their capabilities and patient characteristics while considering partners for tech-enabled interventions. Technology solution providers should take steps to demonstrate strong outcomes from their tools and strategize around reaching Medicare beneficiaries.
Participation requirements include Medicare Part B enrollment, designation of a physician Clinical Director, HIPAA compliance, and applicable FDA requirements. Together, these standards ensure that care quality and patient safety remain central to this landmark initiative.
