CMMI Launches New Technology-Supported Chronic Care Model: What You Need to Know About ACCESS
Updated as of September 17, 2026
The Centers for Medicare and Medicaid Services Innovation Center (CMMI) launched the ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model on July 2026. The 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 began July 5, 2026 and will run through June 30, 2036. It supports continuous, technology-enabled care for Original Medicare beneficiaries with qualifying chronic conditions through recurring Outcome-Aligned Payments (OAPs). 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 initially 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. CMS announced on September 15, 2026 that ACCESS will expand in spring 2027 to include heart failure, chronic obstructive pulmonary disease (COPD), substance use disorders, and tobacco cessation support for nicotine dependence. CMS also announced expanded ongoing support for certain bone, joint, and mobility conditions beyond the initial 12-month care period.
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
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
Outcome-Aligned Payments (OAPs)
Participating organizations receive recurring OAPs for managing qualifying chronic conditions within a defined clinical track. For the current tracks, CMS pays monthly installments equal to one-twelfth of the Medicare portion of the annual allowed amount until 50% of the Medicare portion has been paid. The remaining 50% is withheld and reconciled after the 12-month care period based on clinical performance and substitute-service spending.
| Track | Annual allowed | Medicare portion | Monthly Medicare | Paid before cap* | Withheld / at risk** |
|---|---|---|---|---|---|
| eCKM | $360 | $288 | $24 | $144 | $144 |
| CKM | $420 | $336 | $28 | $168 | $168 |
| MSK | $180 | $144 | $12 | $72 | $72 |
| BH | $180 | $144 | $12 | $72 | $72 |
*Assumes valid monthly claims, continuous beneficiary alignment, and six full monthly installments.
**Maximum potential reconciliation amount; actual payment is subject to performance-based adjustments.
Payment Adjustments
Payment amounts are subject to two potential downward adjustments, a Clinical Outcome Adjustment (COA) and a Substitute Spend Adjustment (SSA), applied during a semi-annual reconciliation.
Between July 5, 2026 - December 31, 2027, under the COA, an organization can earn full payment if at least half of its aligned beneficiaries completing the care period meet all required outcome targets. OAPs may also be reduced through the SSA when beneficiaries receive defined substitute services from other Medicare providers above CMS's threshold.
For beneficiaries residing in rural areas who are aligned to the eCKM or CKM tracks during the Initial Period, CMS adds a fixed $15 payment to help offset higher operational costs associated with connected-device distribution and support.
Integration With Traditional Care
ACCESS is designed to work alongside a beneficiary’s existing care team. Primary care and referring clinicians can:
Refer patients to ACCESS organizations
Receive electronic updates on patient progress
Bill an ACCESS co-management payment when they review a care update and perform a related care-coordination activity.
The standard allowed amount is $30 per service and may be billed up to three times per 12-month care period, per beneficiary, per track.
CMS uses HCPCS G0676 for eCKM/CKM, G0677 for MSK, and G0678 for BH.
Actual payment is geographically adjusted and subject to Medicare sequestration.
Clinical Tracks Under ACCESS
ACCESS launched with four clinical tracks. CMS announced additional tracks for spring 2027; detailed payment amounts and performance specifications for those new tracks are expected later and are not included below.
| 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) stage 3a/b • Atherosclerotic cardiovascular disease (ASCVD), including heart disease |
Control or minimum improvement in BP, lipids, weight, and HbA1c For CKD and diabetes-only participants: Submission of eGFR and urine albumin-creatinine ratio (UACR) data |
| 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 |
|
New Tracks (Spring 2027) |
• Heart failure • COPD • Substance use disorders • Tobacco cessation/nicotine dependence |
Detailed measures and payment amounts TBD; CMS has described a focus on measurable gains in function, symptoms, quality of life, and condition-specific outcomes. |
Who Can Participate?
ACCESS is designed for Medicare-enrolled organizations that can deliver chronic care through technology supported workflows and take accountability for measurable outcomes. CMS reports that 160 organizations are currently participating and that three out of four people with Medicare qualify for at least one ACCESS track. CMS maintains a public directory to help beneficiaries and referring clinicians identify participating organizations and covered conditions.
Eligible ACCESS participants include any Medicare Part B enrolled providers or suppliers, excluding DMEPOS and laboratory suppliers and must designate a Medicare-enrolled physician Clinical Director. Organizations not currently enrolled in Part B must enroll before joining.
Participants must also meet several baseline requirements. For an ACCESS-aligned beneficiary during an active care period, the ACCESS participant and its affiliated entities may not submit other Medicare fee-for-service claims for services furnished to that beneficiary; only ACCESS model G-codes may be billed by the participant for the aligned care. Organizations without an existing Medicare billing structure should plan for the operational complexity of Part B enrollment, PECOS/TIN/NPI setup, affiliation rules, and model-specific billing before they apply.
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
ACO overlap is allowed, but the financial treatment changes over time. CMS anticipates that ACCESS OAP expenditures will not affect Medicare Shared Savings Program or ACO REACH benchmark and performance-year calculations in performance years (PYs) 2026 or 2027. Beginning in PY 2028, ACCESS OAP expenditures will be included in those calculations. ACOs and other risk-bearing organizations can refer aligned beneficiaries to ACCESS participants and may use the CMP for documented co-management activities.
Timeline and Key Dates
Applications: Accepted on a rolling basis through April 1, 2033
January 1, 2027 cohort: Applications submitted after the initial launch deadline and before October 1, 2026 are considered for this start date under the current Request for Applications (RFA).
New clinical tracks: Heart failure, COPD, substance use disorders, and tobacco cessation support begin on April 2027
Model duration: July 5, 2026-June 30, 2036
How You Can Prepare
With the model now underway, the key question is how organizations can position themselves to participate successfully as CMS expands the marketplace. The combination of defined payment amounts, performance accountability, fee-for-service restrictions, and rolling entry points makes both clinical readiness and Medicare billing infrastructure important. 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
Because CMS is accepting applications on a rolling basis, organizations can use the additional entry points to address enrollment, billing, clinical, and data-readiness gaps before selecting a cohort.
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.