CMS unveils ACCESS, a 10‑year pilot to expand tech‑enabled chronic care in Original Medicare

CMS officials outlined ACCESS, a nationwide, 10‑year voluntary model beginning July 5, 2026, designed to expand access to technology‑enabled chronic care for people with Original Medicare. The Centers for Medicare & Medicaid Services Innovation Center created ACCESS to test an outcome‑aligned payment (OAP) that conditions full payment on measurable clinical results rather than the volume of services.

"Access protects federal taxpayers by conditioning full payment on clinical outcomes," said Pooja Nair, an Access Model co‑lead, explaining that participants will earn full payments only when beneficiaries meet defined goals such as lower blood pressure or improved hemoglobin A1c.

The model groups qualifying conditions into four clinical tracks: early cardio‑kidney‑metabolic (ECKM) for prevention; cardio‑kidney‑metabolic (CKM) for more advanced disease; musculoskeletal (MSK) for chronic pain; and behavioral health for depression and anxiety. Access participants will be responsible for managing all qualifying conditions a beneficiary has within an enrolled track.

Patients may enroll directly with an Access participant or be referred by a primary care practitioner (PCP) or other clinician; once aligned, participants must share structured care plans and updates with the beneficiary’s PCP or referring clinician at the start of care, at any clinical escalation, and at care completion. CMS plans to publish an Access Participant Directory and, beginning in fall 2027, risk‑adjusted outcomes for participating organizations.

The CMS Innovation Center said the model aims to expand patient choice, promote transparent performance reporting and align payments with health outcomes while protecting federal spending. The webinar and slides emphasized that the OAP is intended as a replacement payment for participating entities for covered services during active care periods rather than an add‑on to fee‑for‑service billing.

Next procedural steps: ACCESS launches July 5, 2026; CMS will post the participation agreement and will announce selected participants after they sign that agreement. Slides, recordings and the transcript will be posted on the ACCESS model webpage, and questions may be directed to the model help desk email.