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HHS, CMS unveil 10‑year 'Access' payment model to bring digital care into Medicare
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Summary
HHS and CMS on a virtual event launched the Access model, a 10‑year voluntary, outcome‑aligned payment option intended to reimburse technology‑enabled care for Medicare Part B beneficiaries; officials outlined enrollment criteria, payment incentives, patient protections and a timeline with applications opening in January and the model beginning in July.
Jacob Schiff, chief AI and technology officer at the CMS Innovation Center, and HHS and CMS leaders announced the Access model, a 10‑year voluntary program that ties Medicare payments to measurable health improvements and aims to scale technology‑enabled care for chronic conditions.
The Access model will let Medicare‑enrolled organizations enroll patients in condition "tracks," capture baseline measures such as blood pressure and A1C, and receive predictable payments that rise when patients meet defined outcome goals, officials said. Jacob Schiff said participants "will receive predictable payments for helping patients manage qualifying chronic conditions and they'll earn the full amount when that patient meets measurable health goals relative to where they started."
Why it matters: The initiative is designed to address rising health spending and gaps in chronic‑disease care by shifting payment from discrete activities to outcomes. "Access is going to supercharge the CMS health tech ecosystem and health care everywhere," Amy Gleason said, describing the model as a way to reward results and expand use of apps, connected devices and remote monitoring.
How it will work: Organizations must be Medicare Part B‑enrolled providers or suppliers, comply with licensure and data privacy requirements, and designate a clinician responsible for clinical oversight. The model permits flexible care delivery—virtual, asynchronous or in‑person—and includes a new co‑management payment that referring primary care clinicians can bill without beneficiary cost sharing for documented care‑plan review and coordination.
Patient protections and transparency: CMS will maintain a public directory of Access participants, including conditions treated and risk‑adjusted outcomes, and will monitor and publish outcomes to promote accountability. Officials said that Access participants who use certain devices in coordination with FDA under the TEMPO pilot must obtain enhanced consent from enrolled beneficiaries and follow applicable privacy and security standards.
Timeline and participation: Jacob Schiff said the request for applications would be released "very shortly," the application window will open in January, the model is slated to begin in July, and the application deadline will be April 1 with rolling admissions. Geeta Dio, chief of staff at the CMS Innovation Center, added that more than 250 organizations submitted intent to apply in the model's early days and CMS expects participation to grow over the 10‑year period.
What officials said about scale and payment: Deputy Secretary Jim O'Neil and others framed Access as a way to build evidence for broader reimbursement approaches. O'Neil said the model will help design a reimbursement framework for technology and AI in health care and that HHS is exploring reimbursement pathways to let innovators scale profitably while improving outcomes.
Next steps: CMS will publish application materials and more detailed implementation guidance in the coming weeks; organizers said the model is voluntary and intended to be compatible with other payers and future value‑based arrangements.
Ending: Organizers closed the event by emphasizing collaboration across CMS, FDA, clinical societies and the private sector to implement Access and measure whether technology‑enabled interventions reduce costs and improve patient outcomes.
