CMS introduces ACCESS model for chronic care

The Centers for Medicare & Medicaid Services (CMS) unveiled the ACCESS Model, a decade-long initiative starting July 2026 designed to advance technology-driven chronic care for Medicare beneficiaries. ACCESS aims to broaden reimbursement for telehealth, remote monitoring, digital therapeutics, and other FDA-authorized health technologies, moving beyond traditional office-based visits.

Shifting payment toward outcomes

ACCESS departs from fee-for-service payments by adopting an outcome-aligned approach. Providers enrolled in the program will receive recurring payments for managing chronic conditions, with full reimbursement contingent on demonstrated health improvements. Key clinical tracks include cardiovascular, kidney, metabolic diseases, musculoskeletal pain, and behavioral health conditions such as depression and anxiety. These conditions collectively affect about two-thirds of Original Medicare participants.

This model enforces accountability by linking payment to measurable clinical results, including blood pressure control, stabilized blood glucose, and mental health stabilization. While this fosters high-quality care delivery, providers must navigate challenges related to patient complexity, social determinants of health, and consistent treatment adherence.

Implementation framework and regulatory support

Participation in ACCESS is voluntary and open to Medicare Part B providers who satisfy licensure and privacy standards. CMS will accept applications beginning January 2026, with an initial deadline in spring 2026 for a July program start. To facilitate adoption, CMS plans to launch an “ACCESS Tools Directory” featuring software and hardware solutions such as remote monitors, interoperable data platforms, and digital health applications vetted for use in the program.

Parallel to CMS efforts, the FDA is conducting the TEMPO Pilot, a complementary initiative allowing select digital health devices without full clearance to operate under regulatory “enforcement discretion.” This collaboration enables real-world data collection while supporting innovation in digital therapeutics and monitoring.

Implications for IDD and behavioral health providers

ACCESS could represent a significant opportunity for IDD and behavioral health agencies that emphasize technology-enabled care. By reimbursing telehealth and remote monitoring under outcome-based payments, the program encourages integrating digital tools that extend care beyond traditional settings. This move may accelerate adoption of remote patient monitoring and digital interventions tailored to individuals with intellectual and developmental disabilities.

However, the transition to outcome-based reimbursement requires robust data collection and care coordination to demonstrate consistent health gains. Providers will need to invest in compliance readiness, technology infrastructure, and outcome measurement capabilities to maximize program benefits.