What Is the CMS ACCESS Model?

Partner News | Published: Thursday, September 17, 2026

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Summary

The Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model is a 10-year national test launched by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. It runs from July 5, 2026 through June 30, 2036, and it tests a genuinely different question than most Medicare payment programs: can paying for outcomes, rather than paying for specific services or devices, actually improve how chronic disease is managed at scale?

For years, U.S. healthcare reform has cycled through pilots, demonstrations and acronym-heavy experiments that promised to make care more coordinated, efficient and equitable. Many produced lessons, while fewer produced durable structural change. What makes this announcement notable is that CMS appears to be pushing beyond limited experimentation and toward broader operational scale.

That matters because the central challenge in American healthcare has never been a shortage of ideas. It has been the inability to implement them consistently across a fragmented system shaped by incompatible incentives, uneven provider capabilities, and persistent disparities in access and outcomes.

Why the ACCESS Program Matters

At its core, ACCESS reflects the next phase of accountable care. It builds on the Accountable Care Organization (ACO) model, but with a sharper focus on equity, community health and the practical realities of serving historically underserved populations.

This is an important correction. Earlier value-based care efforts often rewarded organizations that already had the infrastructure, capital and patient mix to perform well. Safety-net providers and organizations serving more complex populations were frequently asked to compete under rules that did not fully account for the social and structural barriers affecting their patients.

The ACCESS model suggests CMS is trying to address that imbalance. By bringing in a large and diverse cohort, the agency is effectively saying that accountable care must work not only in well-resourced systems, but in the real America of healthcare delivery: fragmented, unequal and operationally messy.

Key Takeaways

• ACCESS focuses on four key clinical tracks:

Track	Qualifying Conditions	Outcome-Aligned Payment Measures
eCKM	Hypertension, OR two or more of: dyslipidemia, obesity/overweight with central obesity, prediabetes	Control or minimum improvement in BP, lipids, weight and HbA1c
CKM	One or more of: diabetes mellitus, CKD, ASCVD	Control or minimum improvement in BP, lipids, weight and HbA1c; [CKD and diabetes only] Submission of eGFR and uACR data
MSK	Chronic musculoskeletal pain	Minimum improvement in pain intensity, interference and overall function (assessed via validated PROM)
BH	One or more of: depression, anxiety	Minimum improvement in symptoms (PHQ-9 for depression, GAD-7 for anxiety); Submission of PGIC at end of period; WHODAS 2.0 12-item functional assessment (optional in Year 1)

ASCVD = atherosclerotic cardiovascular disease; BP = blood pressure; CKD = chronic kidney disease; eGFR = estimated glomerular filtration rate; GAD-7 = Generalized Anxiety Disorder-7; HbA1c = hemoglobin A1C; PGIC = Patient Global Impression of Change; PHQ-9 = Patient Health Questionnaire-9; PROM = patient-reported outcome measure; uACR = urine albumin-creatinine ratio; WHODAS = World Health Organization Disability Assessment Schedule 2.0.

Modified from Centers for Medicare & Medicaid Services. CMS ACCESS Technical Frequently Asked Questions. CMS.gov. Published March 18, 2026. Accessed September 11, 2026. https://equently-asked-questions.

• ACCESS provides participating organizations with predictable, recurring payments for helping patients manage qualifying chronic conditions. Full payment depends on achieving measurable health outcomes, such as improvement or control of blood pressure.
• CMS built the model to expand access to technology-supported chronic care, improve patient choice, and test whether outcomes-based payment can lower Medicare spending without compromising quality.
• The model covers roughly two out of every three people with Original Medicare, through four initial clinical tracks.
• Rather than paying for a specific set of services, the model rewards results, giving care teams flexibility to use the technology, clinical tools and care approaches that best fit each patient.
• To participate, organizations must be enrolled in Medicare Part B as providers or suppliers and designate a physician Clinical Director responsible for care quality and compliance.
• Patients with Original Medicare may sign up directly with a participating organization or enroll after a referral from their primary care practitioner or another clinician.

What This Means for CV Administrators and Clinicians

• Cardiovascular conditions sit at the center of this model more than any other specialty area. Two of the four initial tracks, covered in detail in Report 2, are built almost entirely around cardiovascular and cardiometabolic risk factors: hypertension, lipids, obesity, prediabetes, diabetes, CKD and ASCVD. CMS has been explicit that cardiovascular disease is one of the clearest cases where prevention and better between-visit management can change outcomes and cost trajectory at the same time.
• This is a genuinely new payment option built around outcomes rather than encounters, with a long runway and rolling admissions rather than a single hard deadline, which gives you room to understand it fully before deciding whether to participate, refer or wait.
• Because payment follows results, the model rewards structured, proactive management of a patient's condition over time, a different operating rhythm than most fee-for-service work is built around.

ACCESS Model Key Takeaways

To learn more, access key points and next steps on the following topic:

• Which CV-Specific Patients Qualify: The Clinical Tracks
• How Quality and Payment Are Determined

Reference:

1. Centers for Medicare & Medicaid Services. CMS ACCESS Technical Frequently Asked Questions. gov. Published March 18, 2026. Accessed September 11, 2026. https://www.cms.gov/priorities/innovation/access-technical-frequently-asked-questions.

About this series

This series is made possible in partnership with ALYKA Health (Digital Health Partner), which was named among the first 150 organizations selected to participate in the CMS ACCESS Model and is the first MedAxiom partner to do so. 

 

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