CMMI Launches New Technology-Supported Chronic Care Model: What You Need to Know About ACCESS
The Centers for Medicare and Medicaid Services Innovation Center (CMMI) has announced the ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model, a new ten-year voluntary payment model designed to support continuous, technology-enabled care for Medicare beneficiaries with common chronic conditions. The model introduces a recurring, outcome-aligned payment that provides a predictable source of funding for modern care tools such as remote monitoring, digital therapeutics, and structured coaching programs. This funding structure is intended to support sustained engagement and measurable improvements in clinical outcomes.
ACCESS signals a meaningful shift in how Medicare may support the use of technology in chronic care. The model creates a straightforward funding pathway for organizations that combine clinical oversight with continuous digital engagement and is designed to make modern care tools more accessible and sustainable within Original Medicare. It also arrives at a time when commercial coverage for remote monitoring is contracting, which suggests that new payment approaches may be needed to support technology enabled care at scale. Taken together, these developments indicate growing federal interest in testing whether Medicare can support continuous, technology supported management as part of standard chronic care, particularly for beneficiaries in rural and underserved communities.
What Is ACCESS?
ACCESS is a voluntary model beginning July 1, 2026, that tests whether Medicare can support continuous, technology-enabled care for beneficiaries with common chronic conditions. The model is structured to create a stable funding pathway for technology platforms and programs that provide ongoing monitoring, engagement, coaching, and condition-specific support that are difficult to sustain under traditional fee-for-service rules.
ACCESS reflects a shift in CMMI’s investment strategy. Rather than centering the model on changes in office-based care, the approach emphasizes the use of digital tools and continuous support services that operate alongside clinical care. The recurring payment is intended to fund technologies and services such as remote monitoring, digital therapeutics, behavioral support programs, and other modern care tools that enable longitudinal management.
The model focuses on highly prevalent and costly conditions in Medicare, including hypertension, diabetes, chronic musculoskeletal pain, depression, and related cardiometabolic disorders. These conditions are well-suited to continuous, data-driven management, and the technology market already offers mature solutions in these areas. Through ACCESS, CMMI is testing whether integrating these solutions into the Medicare benefit through a predictable payment can improve outcomes and broaden access to modern chronic care, particularly in rural and underserved communities.
Model Goals
CMS outlines four core goals for ACCESS:
Empower people to achieve their health goals by improving patient access to new technology-supported care options to manage their chronic conditions.
Expand clinicians’ ability to offer innovative, technology-enabled care through a straightforward payment pathway.
Ensure that technology-supported care is clinician-guided, accountable, and coordinated.
Promote transparency by publishing risk-adjusted health outcomes of technology-supported care so patients and referring clinicians can make informed choices.
How ACCESS Works
Outcome-Aligned Payments
Participating organizations receive recurring payments to manage chronic conditions within a defined clinical track. Full payment is earned only when outcome targets are achieved, such as improvements in blood pressure, A1c, weight, lipids, pain scores, or validated behavioral health measures.
Performance is assessed based on the share of an organization’s patients who meet their outcome goals, and CMS will raise minimum thresholds over time. Although this structure is intended to balance accessibility with accountability, several important details remain to be clarified in the forthcoming Request for Applications. Key questions include how CMS will set the payment amounts for each track, how the methodology for outcome thresholds will be established, and how adjustments will be applied across different populations. These factors will shape both the financial viability of participation and the operational strategies that organizations adopt within the model.
Flexible Care Delivery
ACCESS supports integrated, technology-enabled care that may include:
Clinician consultations
Lifestyle and behavioral support
Therapy and counseling
Patient education and care coordination
Diagnostic ordering and interpretation
Use or monitoring of FDA-authorized devices or software
In-person, virtual, asynchronous, and device-supported modalities
Rural Adjustment
A fixed adjustment applies for eligible rural beneficiaries, supporting access and model viability in areas with limited care options.
Integration With Traditional Care
Primary care and referring clinicians can:
Refer patients to ACCESS organizations
Receive electronic updates on patient progress
Bill a new co-management payment for reviewing updates and coordinating care (e.g., medication changes or problem list updates)
Clinical Tracks Under ACCESS
CMS will launch four clinical tracks, grouping-related conditions treated with similar types of care:
| Track | Qualifying Conditions | Outcome-Aligned Payment Measure |
|---|---|---|
| eCKM |
High blood pressure (hypertension), or two or more of the following: • Dyslipidemia • Obesity or overweight with marker of central obesity • Prediabetes |
• Control or minimum improvement in blood pressure (BP), lipids, weight, and hemoglobin A1c (HbA1c) |
| CKM |
One or more of the following: • Diabetes mellitus • Chronic kidney disease (CKD) • Atherosclerotic cardiovascular disease (ASCVD), including heart disease |
• Control or minimum improvement in BP, lipids, weight, and HbA1c • For CKD and diabetes-only: Submission of eGFR and urine albumin-creatinine ratio (UACR) |
| MSK | Chronic musculoskeletal (MSK) pain | • Minimum improvement in pain intensity, interference, and overall function (validated PROM) |
| BH |
One or more of the following: • Depression • Anxiety |
• Minimum improvement in symptoms (PHQ-9 for depression; GAD-7 for anxiety) • Submission of WHODAS 2.0 (12-item) for overall function |
Each track includes condition-specific measures and outcome targets based on clinical guidelines, with most tracks offering an initial year of care followed by an optional continuation period at a reduced rate.
Who Can Participate?
ACCESS is designed for organizations that already deliver chronic care through technology supported workflows. These groups are the most likely to participate successfully because the model pays for measurable improvements in clinical outcomes rather than task-based activities. Organizations with existing digital infrastructure, virtual care capacity, and multidisciplinary teams will enter the model with a clear advantage.
Eligible participants include any Medicare Part B enrolled organization other than DMEPOS and laboratory suppliers. Organizations not currently enrolled in Part B must enroll before joining.
Participants must also meet several baseline requirements. These include compliance with state licensure rules, HIPAA, and relevant FDA regulations. Each organization must designate a physician Clinical Director to oversee quality, safety, and compliance. Participants must also use secure and interoperable systems, including CMS APIs, for patient enrollment, data exchange, and reporting.
ACCESS supports care delivered in-person, virtually, asynchronously, and through FDA-authorized devices or software. This structure makes participation especially well suited for:
Virtual chronic care companies
Digital health platforms
Hybrid technology and clinical groups
Provider organizations with established remote monitoring or asynchronous care workflows
An important open question concerns how ACCESS participation will interact with participation in ACO models. CMS has indicated that some degree of overlap in providers and beneficiaries is expected, but the financial implications of this overlap and any potential exclusions have not yet been defined. These details will be important for organizations that participate in multiple models and will require clarification in the Request for Applications.
Timeline and Key Dates
Request for Applications (RFA): Coming soon
Interest Form: Available now for notifications
Applications Open: January, 2026
Initial Deadline: April 1, 2026
Model Launch: July 1, 2026
Duration: 10 years
How You Can Prepare
By aligning payment with clinical improvement and offering flexibility for technology-supported care, the model opens new opportunities for organizations delivering prevention, disease management, and continuous support.
Organizations considering ACCESS should begin preparing by:
Reviewing eligibility and participation requirements
Assessing readiness for outcome-aligned payments
Evaluating data, quality, and reporting capacity
Understanding how ACCESS integrates with traditional care workflows
Mapping which clinical tracks align with current services and infrastructure
As the RFA approaches, early planning will be critical for successful participation.
How Coral Can Help
Coral Health Advisors can support your organization in evaluating model requirements, assessing operational readiness, and preparing for the ACCESS application process. Our team works with technology driven innovators and other emerging care models to help them understand how federal programs are evolving and how to position their services within new payment structures. This includes advising on how to align existing capabilities with the direction signaled by ACCESS and other recent CMMI initiatives, as well as identifying practical steps to strengthen readiness for outcome based payment and continuous, technology supported care.
Contact us to learn how we can help your team plan for participation in ACCESS.