A new model for technology‑supported chronic care

Recent advances in health technology have the potential to transform chronic care, yet Original Medicare has struggled to keep pace. Its fee‑for‑service structure reimburses only a fixed set of services, leaving little room to support newer tools such as remote patient monitoring devices and virtual care platforms.

The ACCESS Model tackles this long‑standing gap by introducing Outcome‑Aligned Payments (OAPs), a new way for Medicare‑enrolled care organizations to be reimbursed for managing chronic conditions. Instead of paying for a checklist of services, the model provides recurring payments that are earned in full only when patients show measurable improvements in their health. Progress is assessed relative to each person’s baseline—for example, helping someone with hypertension bring their blood pressure down by 10 mmHg.

By shifting the focus from the volume of services delivered to the results patients achieve, ACCESS gives clinicians the room to use modern, technology‑supported tools in whatever combination best supports their patients. This approach encourages care teams to tailor interventions, integrate digital health solutions, and prioritize strategies that genuinely move the needle on chronic disease management.

To support safe and effective care, participating organizations must enroll in Medicare Part B as providers or suppliers and comply with all applicable state licensure requirements, HIPAA requirements, and FDA requirements—or fall under FDA enforcement discretion. Each organization must also designate a physician Clinical Director responsible for clinical oversight and compliance.

Participation is voluntary, and providers can apply through the CMS ACCESS Model webpage. The model will run for 10 years, beginning July 5, 2026.

Key points to understand:

• Problem: Today, people with Original Medicare have limited access to technology-supported care services for managing their chronic conditions because of Medicare payment barriers.
• Solution: Through ACCESS, CMS will test 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.
• Outcomes: Patients will have more options to help them meet their health goals, providers will gain new partners to help them co-manage their patients’ health, and Original Medicare will have a way to pay care organizations developing technology-supported services.
• Strategy: ACCESS supports disease prevention and health promotion by empowering people who have Medicare and clinicians with more choices.

What does technology-supported care include?

Technology-supported care may include FDA-approved remote monitoring devices that patients can wear continuously, or take on and off, for providers to access relevant health data such as sleep, blood sugar, and blood pressure. It may also include software for patients to virtually see providers and apps to coach patients in making healthy lifestyle changes. These are tools for providers that will supplement in-person care, not completely replace it. Remote monitoring devices and virtual visits help ensure patient accountability and follow-up in-between office visits. Other aspects of care may include

• Clinician consultations
• Lifestyle and behavioral support (nutrition, exercise, smoking cessation)
• Therapy and counseling
• Patient education and care coordination
• Medication management
• Ordering and interpreting diagnostic tests and imaging

What conditions does ACCESS focus on?

According to CMS, ACCESS will focus on four clinical tracks addressing some of the most common chronic conditions.

• Early cardio-kidney-metabolic conditions (eCKM): hypertension (high blood pressure), dyslipidemia (high or abnormal lipids, including cholesterol), obesity or overweight with marker of central obesity, and prediabetes
• Cardio-kidney-metabolic conditions (CKM): diabetes, chronic kidney disease (3a or 3b), and atherosclerotic cardiovascular disease, including heart disease
• Musculoskeletal conditions (MSK): chronic musculoskeletal pain
• Behavioral health conditions (BH): depression and anxiety

Each track includes condition‑specific measures and outcome targets based on clinical guidelines. These may include improvements in biomarkers such as blood pressure, HbA1c, lipids, or weight, or improvements in validated patient‑reported outcomes related to pain, mood, or function. Most tracks offer an initial year of care with an optional continuation period at a reduced rate to support ongoing patient progress.

Supporting equity and accountability

ACCESS is structured to expand care options while ensuring that organizations delivering technology‑supported services remain accountable for meaningful results. To strengthen access in underserved communities, CMS will apply a fixed payment adjustment for rural patients enrolled in qualifying tracks, helping ensure that geography does not limit participation. Payments will be based on the overall share of an organization’s patients who meet their outcome targets, allowing high‑performing organizations to earn full payment through strong aggregate results even when some individual patients do not reach their specific goals. CMS will also publish risk‑adjusted outcomes to highlight excellent clinical performance and give patients clearer insight into the quality of care available to them.

Apply for ACCESS:

The ACCESS Model Request for Applications is now available on the CMS website. To be considered for the model’s first performance period beginning July 5, 2026, applications must be submitted via the Participant Portal by April 1, 2026. Applications received after this date will be considered for a January 1, 2027 start. Click here for more information about the ACCESS Model and to find the provider application.

Conclusion

The ACCESS Model represents a significant step toward modernizing how Medicare supports chronic care. By aligning payment with outcomes, expanding the use of technology‑supported services, and strengthening accountability and transparency, CMS aims to give patients more tools to manage their health while giving clinicians more flexibility to deliver effective, continuous care. As the model rolls out over the coming decade, it has the potential to reshape chronic disease management for millions of Medicare beneficiaries and to accelerate the integration of innovative technologies into everyday clinical practice.