CMS Introduces ACCESS Model to Boost Digital Health in Medicare

2025-12-05 digitalcare

Washington, D.C., Friday, 5 December 2025.
The ACCESS Model incentivizes healthcare providers to integrate technologies like telehealth for chronic conditions, using outcome-based payments to enhance patient care and streamline reimbursement.

A New Era for Chronic Care Management

The Centers for Medicare & Medicaid Services (CMS) has launched the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model, a revolutionary approach aimed at integrating digital health technologies into chronic care management. This voluntary ten-year initiative, announced on December 4, 2025, seeks to redefine care for chronic conditions such as hypertension, diabetes, musculoskeletal pain, and depression by focusing on outcome-aligned payments rather than traditional service-based reimbursements [1][2][3].

Outcome-Aligned Payments and Technological Integration

Under the ACCESS Model, participating organizations will receive recurring payments for managing patients’ qualifying chronic conditions, with a strong emphasis on achieving measurable health outcomes. This model marks a significant shift from previous frameworks by prioritizing clinical improvements and providing healthcare providers the flexibility to use various digital tools, such as telehealth services, wearables, and mobile applications, to enhance patient care [1][4]. The model encourages the use of FDA-cleared technologies and supports their evaluation based on patient outcomes, thereby removing traditional reimbursement limitations [5].

Eligibility and Participation Dynamics

To participate in the ACCESS Model, organizations must be enrolled in Medicare Part B and comply with federal and state regulations. They must also appoint a physician Clinical Director responsible for overseeing quality and safety. Notably, the model allows for direct beneficiary enrollment, offering individuals with Original Medicare the opportunity to either enroll directly with an ACCESS participant or be referred by a primary care provider [6][7]. This flexibility is designed to increase patient choice and ensure comprehensive management of chronic conditions across various clinical tracks [8].

Implications for Healthcare Providers and Technology Companies

The ACCESS Model presents a significant opportunity for healthcare providers and technology companies to innovate care delivery. By aligning payments with patient outcomes, the model incentivizes the adoption of advanced digital health solutions and promotes interoperability through tools like the ACCESS Tools Directory. This directory will assist providers in identifying software and hardware that support model compliance and enhance care coordination [4][9]. Moreover, participating organizations are encouraged to integrate these technologies into their workflows to optimize chronic care management and improve patient engagement [10].

Bronnen

health technology CMS payment model