Digital technologies are transforming how care is delivered, helping people manage chronic conditions with continuous support beyond the doctor’s office, and CMS is betting on that shift through its new CMS ACCESS Model chronic care payment program now underway in Original Medicare.
What the CMS ACCESS Model Chronic Care Program Actually Does
The ACCESS Model tests an outcome-aligned payment approach in Original Medicare to expand access to new technology-supported care for people managing chronic conditions. The voluntary model focuses on conditions affecting more than two-thirds of people with Medicare, including high blood pressure, diabetes, chronic musculoskeletal pain, and depression. It will run for 10 years beginning July 5, 2026.
How Payments Are Structured Under This Model
Participating organizations receive recurring payments for managing patients’ qualifying conditions, with full payment tied to achieving measurable health outcomes relative to each person’s baseline. Payments and expected outcomes differ by condition and track, and are determined by the overall share of an organization’s patients meeting their targets.
Who Can Participate in the CMS ACCESS Model Chronic Care Program
ACCESS participants must be Medicare Part B-enrolled organizations, excluding durable medical equipment, prosthetics, orthotics, and supplies and laboratory suppliers, and must designate a Medicare-enrolled clinical director to oversee care quality and compliance. Organizations not already enrolled in Medicare Part B must enroll to participate. Medicare Advantage plans are not eligible to participate directly, though they may offer similar services independently.
A Notably Strong Response From Digital Health Companies
CMS greenlit more than 150 digital health companies to participate in ACCESS, a volume that exceeded officials’ expectations. Officials said the enthusiasm suggests modest payment rates and program restrictions did not discourage digital health companies from applying, and most participants had not previously served Medicare patients at all.
The FDA’s Parallel Role Within This CMS ACCESS Model Chronic Care Framework
As part of an ACCESS collaboration, the FDA launched the Technology-Enabled Meaningful Patient Outcomes, or TEMPO, pilot for digital health devices, which provides a pathway for device companies participating in ACCESS to request enforcement discretion from the FDA on certain requirements such as premarket authorization and investigational device rules.
Why This FDA-CMS Coordination Matters
Pairing a Medicare payment pathway with a parallel FDA enforcement discretion pilot addresses two distinct barriers simultaneously, reimbursement uncertainty and regulatory approval timelines, that have historically slowed digital health device adoption within traditional Medicare fee-for-service care.
Industry Support Behind the CMS ACCESS Model Chronic Care Rollout
Leading medical societies have expressed support for CMS’s ACCESS efforts, and major health plans have pledged to offer an ACCESS-aligned payment option for technology-supported chronic care, extending the model’s underlying payment philosophy beyond traditional Medicare fee-for-service into the broader health plan market.
A Rolling Application Structure
The 10-year model offers rolling start dates, with additional cohorts beginning Aug. 17 and Oct. 1, 2026, giving organizations that missed the initial July launch continued opportunities to join the program throughout the year.
What This CMS ACCESS Model Chronic Care Program Means Going Forward
With more than 150 digital health companies already onboarded and additional rolling start dates through the remainder of 2026, the ACCESS Model represents one of CMS’s more ambitious recent efforts to formally integrate technology-supported chronic disease management into traditional Medicare payment structures. Given that most participating companies had no prior Medicare experience, the program’s success may hinge on how effectively these newer digital health entrants navigate Medicare’s compliance, data-sharing, and clinical oversight requirements over the model’s 10-year run.
What to Watch Going Forward
As additional ACCESS cohorts launch throughout 2026 and CMS continues promoting the program to primary care providers and patients, industry observers will likely watch whether outcome-based payments meaningfully improve chronic disease management compared to traditional fee-for-service care. Given the parallel FDA TEMPO pilot’s role in easing regulatory pathways for participating digital health devices, this CMS ACCESS Model chronic care program may serve as an influential test case for how Medicare payment innovation and device regulation can be coordinated to accelerate technology-supported care adoption at scale.
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