What Is the CMS ACCESS Model?
The Centers for Medicare and Medicaid Services (CMS) has officially accepted more than 150 healthcare organizations into its ACCESS Model — short for Advancing Chronic Care with Effective, Scalable Solutions. This landmark program marks a major shift in how Medicare reimburses technology-enabled chronic care.
A New Direction for Medicare Innovation
The CMS Innovation Center (CMMI) first announced ACCESS in December 2025. Since then, the program has attracted strong interest across the digital health industry. The model introduces Outcome-Aligned Payments (OAPs) — a reimbursement structure that pays organizations recurring amounts for managing chronic conditions. Crucially, full payment ties directly to measurable patient health outcomes. This approach rewards results, not just services delivered.
The model runs for 10 years, starting July 5, 2026, and ending June 30, 2036. CMS will accept applications on a rolling basis through 2033, allowing organizations to join multiple entry points over time.
Who Are the 150 Accepted Participants?
The accepted organizations span a wide range of healthcare and digital health sectors. They include mental health apps, wearable device manufacturers, telehealth providers, and chronic disease management startups.
Notable Organizations Approved for ACCESS
Several high-profile names have received provisional approval for the first performance period:
- Noom – weight management and behavioral health
- Verily – Alphabet-backed life sciences company
- Whoop – wearable health monitoring devices
- Concert Health – collaborative care mental health
- HealthTap – virtual primary care
- Withings Medical Group – connected health devices
- Story Health Partners – heart failure management
- Slingshot AI – AI-powered care navigation
Moreover, CMS notes that most accepted organizations have not previously served Medicare beneficiaries. This fact signals the program’s intent to bring entirely new technology-driven care options into the Medicare ecosystem.
How Does the Payment Structure Work?
Traditional Medicare pays for individual services or activities. ACCESS fundamentally changes this model. Instead of billing per visit or device, participating organizations receive recurring monthly payments for managing patients’ qualifying chronic conditions.
Outcome Attainment Threshold (OAT)
Full payment depends on clinical performance. For the first model year, an organization earns 100% of payments if at least 50% of aligned beneficiaries meet their required Outcome-Aligned Payment (OAP) measure targets. If fewer patients meet targets, payments reduce proportionally. This structure creates strong incentives for genuine, outcomes-driven care delivery.
Additionally, CMS will publish risk-adjusted outcomes for all ACCESS participants in a public directory. Patients and referring clinicians can use this directory to make informed decisions.
What Conditions Does ACCESS Cover?
ACCESS targets chronic conditions affecting more than two-thirds of people with Medicare. The four main clinical tracks include:
- Diabetes – blood sugar management and prevention of complications
- Hypertension (High Blood Pressure) – blood pressure reduction targets
- Chronic Musculoskeletal Pain – pain management through technology-enabled approaches
- Depression and Anxiety – behavioral and mental health support
Furthermore, an early Cardio-Kidney-Metabolic (eCKM) track covers dyslipidemia, obesity, prediabetes, and chronic kidney disease risk factors.
Technology-Supported Care Modalities
Participating organizations can deliver care in multiple ways. These include:
- Telehealth consultations and virtual clinician visits
- Wearable devices monitoring blood sugar, heart rate, sleep, and movement
- Mobile apps coaching patients toward behavioral lifestyle changes
- Asynchronous digital tools for continuous patient support between appointments
CMS emphasizes that these tools are especially valuable for patients in rural and underserved communities where in-person care options are limited.
Application Deadline Extended to May 15
CMS originally set April 1, 2026, as the initial application deadline. However, the volume of interest far exceeded expectations. As a result, CMS extended the deadline to May 15, 2026, to allow more organizations to participate from the July 5 launch date.
Organizations that miss the May 15 deadline are not excluded. Instead, their applications receive consideration for a January 1, 2027 start date. CMS continues to review applications on a rolling basis. Organizations can apply through the ACCESS Participant Portal on the CMS website.
Compliance Requirements for Participants
Joining ACCESS is not simply a matter of approval. All accepted organizations must meet several requirements before beginning participation.
Key Compliance Criteria
Every participating organization must:
- Enroll in Medicare Part B as a provider or supplier
- Comply with HIPAA data privacy and security standards
- Meet applicable state licensure requirements
- Satisfy FDA requirements for any devices or digital health tools used
- Appoint a physician Clinical Director to oversee clinical quality and compliance
- Report patient health outcomes to CMS throughout the model period
Care delivery can happen in person, virtually, or asynchronously. However, clinical oversight must remain consistent. Inclusion on the accepted list does not guarantee full participation — organizations must complete all enrollment and compliance steps before launching care under ACCESS.
What This Means for Digital Health
The ACCESS model is a significant win for the digital health industry. For years, companies developing apps, wearables, and virtual care platforms struggled with inconsistent Medicare reimbursement. ACCESS directly addresses this gap by creating a dedicated, recurring payment pathway for technology-enabled chronic care.
Aligning with RFK Jr.’s Health Priorities
The program also aligns with broader health policy priorities. HHS Secretary Robert F. Kennedy Jr. has made fighting chronic disease a centerpiece of his agenda. ACCESS directly supports this by attacking diabetes, hypertension, and metabolic conditions through prevention-focused, tech-enabled care.
The Road Ahead
With the 10-year runway from July 2026 through June 2036, ACCESS gives participating organizations time to build sustainable chronic care programs within Medicare. If the model improves quality without increasing costs — or reduces costs without harming quality — the Secretary of HHS may expand or make it permanent through formal rulemaking.
For digital health companies, providers, and patients alike, ACCESS represents one of the most consequential Medicare innovations in years. The July 5, 2026 launch date is approaching fast — and the window to join the first cohort closes on May 15, 2026.
