Pharma
The Centers for Medicare & Medicaid Services (CMS) has launched a new payment pathway allowing technology-enabled care organizations to participate directly in Medicare under the ACCESS Model, a program set to begin in July 2026. The model allows approved participants to deliver and manage chronic care services for Medicare beneficiaries and receive outcome-based payments without relying on traditional referral structures.
The ACCESS Model, short for Advancing Chronic Care with Effective, Scalable Solutions, targets conditions such as diabetes, hypertension, and behavioral health, which affect a majority of Medicare beneficiaries. CMS states the program is designed to expand access to coordinated care while shifting reimbursement toward measurable health outcomes.
Direct Enrollment Expands Role Of Technology Providers
The program introduces a structure where Medicare patients can enroll in participating care programs supported by technology organizations. This expands the role of non-traditional providers, including digital health platforms, in delivering longitudinal care services.
CMS has selected approximately 150 organizations for initial participation, including digital health companies and care delivery groups. The model is expected to run through 2036, signaling a long-term shift in how Medicare supports chronic care management.
The policy change comes as healthcare providers and payers continue to test new care delivery models to address cost pressures and care fragmentation. Previous efforts by large incumbents to integrate care delivery and technology have faced operational complexity.