What is the ACCESS Model?

The ACCESS Model (Advancing Chronic Care with Effective, Scalable Solutions) is a new CMS Innovation Center program that tests an outcome-aligned payment approach in Original Medicare. It expands access to technology-supported care options that help people improve their health and prevent and manage chronic disease.

The Problem ACCESS Solves

Today, people with Original Medicare have limited access to technology-supported care services for managing their chronic conditions because of Medicare payment barriers.

Digital technologies are transforming the way care is delivered, helping people manage chronic conditions with continuous support beyond the doctor's office:

• Telehealth software helps patients interact with their health care providers from anywhere
• Wearable devices continuously monitor sleep, heart rate, movement, blood sugar and other functions
• Apps coach people to make lifestyle changes that can benefit both their behavioral and physical health

However, Original Medicare has historically lacked a payment option to adequately support these novel technology-supported care approaches. Fee-for-service methodologies pay for a defined set of activities that don't align with how technology-supported care is delivered.

The ACCESS Solution

Through ACCESS, CMS tests a new payment option that emphasizes outcomes over activities, enabling clinicians to offer innovative technology-supported care that improves patients' health and complements traditional care.

How It Works

Participating organizations receive recurring payments for managing patients' qualifying conditions, with full payment tied to achieving measurable health outcomes. The model focuses on clinical improvement or control of a condition based on each person's starting point.

For example, helping a patient with hypertension lower their blood pressure by 10 mmHg.

By rewarding outcomes rather than defined activities (or volume of services delivered), ACCESS gives clinicians greater flexibility to deliver modern technology-supported care in ways that best improve patient health.

Key Benefits

For Patients

• More options to help meet health goals
• Access to innovative technology-supported care
• Continued access to all Medicare benefits and providers
• Voluntary participation with no changes to coverage

For Providers

• New partners to help co-manage patients' health
• Straightforward payment pathway for technology-enabled care
• Greater flexibility in how care is delivered
• Co-management payments for coordination activities

For Care Organizations

• A way to receive Medicare payment for technology-supported services
• Flexibility to innovate in care delivery
• Clear outcome targets and transparent performance metrics

Model Goals

The ACCESS Model aims to:

1. Empower patients — Improve patient access to new technology-supported care options to manage chronic conditions
2. Expand clinician capabilities — Offer innovative, technology-enabled care through a straightforward payment pathway
3. Ensure quality care — Technology-supported care is clinician-guided, accountable, and coordinated
4. Promote transparency — Publish risk-adjusted health outcomes so patients and clinicians can make informed choices

Model Timeline

Next Steps

Ready to learn more? Explore the clinical tracks that ACCESS covers, understand how payments work, or start your application process.

Explore Clinical Tracks

Learn about the four condition areas ACCESS addresses

Understand Payments

How Outcome-Aligned Payments work in ACCESS

Check Eligibility

See if your organization qualifies for ACCESS