January 4, 2026  – The Centers for Medicare & Medicaid Services (CMS) is preparing to introduce a new nationwide demonstration aimed at improving how chronic conditions are managed in Medicare. Known as the Medicare Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model, the initiative is designed to expand the use of technology-supported care while tying provider payments more closely to measurable health outcomes.

The ACCESS Model will run for 10 years and focus on four common and costly conditions: high blood pressure, diabetes, chronic musculoskeletal pain, and depression. CMS says the model is intended to complement, rather than replace, traditional medical care by giving beneficiaries additional tools to prevent disease progression and better manage long-term health needs.

Under the model, participating organizations will offer technology-enabled services such as wearable monitoring devices, digital coaching applications, and telehealth-based support. These tools are intended to help beneficiaries track symptoms, monitor key health indicators, and stay engaged with care teams between in-person visits. CMS has emphasized that care may be delivered in person, virtually, asynchronously, or through other technology-enabled methods, depending on what is clinically appropriate.

 A central feature of the ACCESS Model is its payment structure. Instead of relying solely on traditional fee-for-service reimbursement, CMS will test outcome-aligned payments. Participating organizations will receive recurring payments tied to condition-specific clinical improvement or control targets, measured against a baseline. Full payment will depend on whether measurable health outcomes are achieved, signaling a stronger shift toward value-based care. 

Primary care professionals and other clinicians will play a key role in the model. They may refer eligible Medicare beneficiaries to ACCESS organizations and will receive regular electronic updates on patient progress. To encourage coordination, CMS plans to allow referring clinicians to bill a new co-management payment when they document review of beneficiary updates and take related actions, such as adjusting medications or updating problem lists. The approach is intended to strengthen collaboration between technology-focused care organizations and traditional clinical practices.

Participating ACCESS organizations are expected to provide integrated services that may include clinician consultations, lifestyle and behavioral support such as nutrition and exercise guidance, therapy and counseling, patient education, and care coordination. Medication management, diagnostic testing, and the use or monitoring of Food and Drug Administration–authorized devices are also included among the permitted activities.

To qualify for participation, organizations must enroll in Medicare Part B as providers or suppliers and meet applicable state licensure requirements. They must also comply with federal privacy and safety standards, including the Health Insurance Portability and Accountability Act and relevant FDA rules. Each participating organization will be required to designate a physician clinical director responsible for clinical oversight and regulatory compliance.

CMS has said it will actively monitor clinical performance and publicly report results from the model. The agency believes transparency will help beneficiaries make informed decisions about participating providers while encouraging accountability among organizations.

The first ACCESS performance period is scheduled to begin July 1, 2026. CMS expects to release a request for applications in late 2025 or early 2026, with applications due by April 1, 2026, for organizations seeking to participate in the initial phase. Applications submitted after that date may be considered for a January 1, 2027, start.

As CMS continues to expand its portfolio of innovation models, the ACCESS initiative reflects a broader federal effort to use technology and outcome-based payments to improve care quality, control costs, and better support people living with chronic conditions.