December 19, 2025 – Jacksonville, FL
The Centers for Medicare & Medicaid Services (CMS) recently introduced an innovative national payment and care delivery model called ACCESS – Advancing Chronic Care with Effective, Scalable Solutions. This model represents a strategic shift in how Medicare pays for care, especially for millions of beneficiaries living with chronic conditions, and opens exciting opportunities for health systems, care providers, payers, and digital care partners.
At its core, the ACCESS Model is a 10-year national test of a new payment approach designed to incentivize outcomes and expand access to technology-supported care for people with chronic conditions such as high blood pressure, diabetes, chronic musculoskeletal pain, and depression – conditions that affect roughly two-thirds of Medicare beneficiaries.
Unlike traditional fee-for-service (FFS) payment models that reimburse individual discrete services after delivery, ACCESS introduces an outcome-aligned payment framework. Participating organizations receive recurring payments based on measurable health improvements, not just the volume of services delivered.
This approach encourages care teams to adopt innovative care models, particularly those supported by digital health tools and remote monitoring technologies, which contribute to better chronic disease outcomes.
CMS has long recognized limitations in the traditional Medicare payment system, especially when it comes to supporting continuous, technology-enabled chronic care. Fee-for-service reimbursement can create barriers to scalable, proactive management because providers are paid for visits and procedures, not the results produced by the quality of these visits.
This model was conceived to fill that gap by:
In short, ACCESS is a response to real-world challenges: Medicare beneficiaries face fragmented care, limited access to tech-enabled services, and payment systems that don’t reward proactive management and prevention. The model tests whether realigning incentives can improve outcomes and reduce overall costs in a meaningful way.
For organizations involved in chronic care management (CCM), from health systems and digital health vendors to care coordination teams and value-based care leaders, ACCESS offers an entirely new paradigm:
Rather than billing for individual services, participating providers earn Outcome-Aligned Payments (OAPs) that reflect the health results achieved across populations. This supports the shift from episodic care to sustained, proactive management.
The model explicitly welcomes technology-enabled solutions (including remote monitoring, digital engagement platforms, and integrated data systems) that help patients track and control key health metrics outside the clinic.
ACCESS is designed to “plug into” existing care relationships. It enables primary care providers and specialists to refer patients to ACCESS participants as an extension of the care team, improving continuity and participant engagement.
Unlike many value-based programs that restrict participation to specific provider types or risk arrangements, ACCESS allows a wide range of organizations to apply and participate directly.
With more than 350 technology-enabled organizations already expressing interest, ACCESS has the potential to scale proven chronic care strategies across Medicare at a national level, creating new pathways for long-term digital care adoption.
The ACCESS Model reinforces a clear shift in how chronic care management is expected to function moving forward. Steering away from service-based reimbursement and toward outcomes-driven, technology-enabled care.
By aligning payment with measurable health improvements, ACCESS supports CCM models focused on sustained engagement, longitudinal condition management, and real-world outcomes rather than discrete tasks or time thresholds. This creates greater flexibility for care teams to design programs around what works best for patients.
The model also validates the growing role of digital tools and remote monitoring as core components of chronic care, enabling management beyond the clinic and supporting population-level approaches. As a result, ACCESS lays the groundwork for more scalable, data-driven, and sustainable CCM models that prioritize continuous care and long-term impact.
The CMS ACCESS Model signals a significant shift in chronic care strategy. It is moving payment toward outcomes, fostering technology-enabled care, and expanding access to scalable solutions for one of the costliest and most impactful segments of the healthcare population. For organizations committed to chronic care management, ACCESS represents both a challenge and a major opportunity: to redesign care delivery around patient outcomes and to align your services with a future in which value drives success.
For more information, visit the CMS ACCESS Model FAQ.
Share to© 2026 Wellbox Inc. All rights reserved | Privacy | Notice of Patient Privacy Practices | Terms of Use