CMS extends ACCESS Model application deadline
The Centers for Medicare & Medicaid Services (CMS) recently extended the application deadline for participating in the Advancing Chronic Care Model with Effective, Scalable Solutions (ACCESS) Model to May 15, 2026.
The ACCESS Model
The ACCESS Model is a new voluntary 10-year, outcome-based national payment model designed to expand access to technology-supported care for people with chronic conditions and to provide flexibility for care teams to use technology, clinical tools, and care approaches to address patient needs. This test program will initially have four clinical tracks based on health conditions:
| Track | Qualifying Condition |
| Early Cardio-Kidney-Metabolic (eCKM) |
Hypertension (high blood pressure); or 2 or more of:
|
| Cardio-Kidney-Metabolic (CKM) |
Any of:
|
| Musculoskeletal (MSK) |
Chronic musculoskeletal pain (lasting more than 3 months) |
|
Behavioral Health (BH) |
Depression or anxiety |
The eCKM and CKM tracks both relate to cardio-kidney-metabolic syndrome, which is a common health disorder arising from interactions among obesity, diabetes, chronic kidney disease and cardiovascular disease, and includes conditions such as heart failure, atrial fibrillation, coronary heart disease, stroke, and peripheral artery disease.
Each ACCESS participant will be responsible for managing all beneficiary qualifying conditions in the track and supporting integrated, patient-centered care. Additional tracks will be considered in the future. Participating organizations are allowed to participate in a single track or multiple tracks.
The ACCESS Model is open to Medicare beneficiaries who are in Original Medicare and have chronic conditions that fall within any of the ACCESS Model’s clinical tracks. Beneficiary alignment with a participant is voluntary and prospective. People can sign up in one or more tracks, and in some cases may be randomly assigned to a control group in order to help CMS evaluate the ACCESS Model. Beneficiary informed consent must be obtained and documented in the beneficiary’s record.
A broad range of Medicare Part B-enrolled providers or suppliers (other than durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) and laboratory suppliers) can participate in the ACCESS Model. In order to be eligible, an organization must have a Tax Identification Number (TIN), be enrolled in Medicare Part B as a provider or supplier, comply with applicable licensure, HIPAA and FDA requirements, designate a physician clinical director for care quality and compliance, and apply for participation and enter into a Participation Agreement with CMS. Participation is at the organizational TIN level.
Each ACCESS participant will collect baseline measures for each patient as benchmarks to track improvement or control and will be responsible for helping patients achieve their targets. CMS will monitor performance and publish a directory of ACCESS participants, including conditions treated and risk-adjusted clinical outcomes.
The ACCESS Model is intended to support care coordination with each beneficiary’s primary care practitioner (PCP), referring clinicians and other care team members. A participant must ensure that all physicians and non-physician practitioners furnishing or supervising care are Medicare-enrolled participating providers or suppliers who have reassigned their Medicare billing rights to the participating TIN, and must submit and maintain an up-to-date roster of all Medicare-enrolled practitioners furnishing or supervising care under the TIN. Participants are required to share care plans and clinical updates, and can request Medicare claims data for aligned beneficiaries.
Payment
ACCESS participants will receive Outcome-Aligned Payments (OAPs) based on achieving measurable health outcomes for managing a patient’s qualifying conditions, with a standard monthly per-patient payment for managing all qualifying conditions within the track and full payment contingent on achieving track-specific OAP clinical outcome targets. Payment will be reconciled semi-annually based on assessed performance for each participant’s patient panel reflecting a clinical outcomes adjustment and a substitute spend adjustment. OAPs will not include medications, laboratory tests, imaging, or DMEPOS, which may be coordinated by a participants but billed to Medicare by financially unaffiliated entities.
In order to further support care coordination and engagement, PCPs and referring clinicians will be allowed to bill for a co-management payment (approximately $30 per service, or $10 for onboarding and initial setup, subject to the geographic and standard Medicare adjustments but without beneficiary cost-sharing) for reviewing updates and documenting related care-coordination actions, subject to an annual cap of approximately $100 per beneficiary.
ACCESS participants will have the flexibility to forego the collection of beneficiary cost-sharing for OAPs, but must implement a uniform policy consistent across all patients. CMS has determined that the anti-kickback safe harbor for CMS-sponsored model arrangements and patient incentives (42 CFR 1001.952(ii)) will be available for foregone beneficiary cost-sharing. Please keep in mind that multiple elements need to be satisfied in order to be protected under this safe harbor.
Application process
CMS plans to accept applications on a rolling basis from 2026 through 2033 to allow different starting times for ACCESS Model participation, with the first period starting July 5, 2026. The ACCESS Model Request for Applications is available here.
More than 150 health care organizations have been accepted to participate in the ACCESS Model (see here). CMS noted that most of the participating organizations have not previously served Medicare beneficiaries and that the participants provide technology-supported care options to help people manage chronic conditions such as high blood pressure, diabetes, chronic pain, and depression. Medicare enrollment is required for participation in the ACCESS Model but is not required prior to application, although CMS encourages applicants to start the enrollment process early because final approval will not be provided before the enrollment process is completed.
CMS extended the deadline from April 1, 2026, to May 15, 2026 to participate in the ACCESS Model starting July 5, 2026. The next participation date (for applications received after the May 15 extended deadline) will be January 1, 2027.
FDA TEMPO pilot
The U.S. Food and Drug Administration (FDA) recently established the Technology-Enabled Meaningful Patient Outcomes (TEMPO) for Digital Health Devices Pilot (the TEMPO pilot) in collaboration of CMS to promote the use of digital health devices in support of the ACCESS Model even if generally required FDA premarket authorization has not been obtained for the devices.
The TEMPO pilot allows manufacturers of digital health devices to request that FDA exercise enforcement discretion and not enforce certain FDA premarket authorization or other requirements when a device is offered to or by ACCESS participants for an intended use to improve patient outcomes in providing care under the ACCESS Model. ACCESS participants can then use the device to mitigate patient risks and collect, monitor, analyze and report real-world performance data that may support assessment of safety, performance and potential future FDA marketing submissions and data collection.
Before using a devise in the TEMPO pilot an ACCESS participant will be required to obtain enhanced consent from its enrolled beneficiaries.
Information on the TEMPO pilot is available here.
Potential ACCESS expansion
The ACCESS Model is a test model initially limited to four tracks for Original Medicare beneficiaries, subject to future evaluation of whether this approach can improve health outcomes, enhance patient choice and reduce overall Medicare costs. New tracks may be added in the future to cover additional conditions. Although Medicare Advantage enrollees are not included in the ACCESS Model, Medicare Advantage plans may offer similar programs.
The influence of the ACCESS Model is likely to extend well beyond Medicare and the initial four tracks. CMS has emphasized that the ACCESS Model is designed to support potential adoption by other payers and alignment across payers. In February 2026 CMS announced that major health payers covering 165 million Americans with Medicare Advantage, Medicaid and private health insurance plans pledged to adopt outcomes-based payment arrangements that align with the core principles of ACCESS Model by January 1, 2028.
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The ACCESS Model and similar programs will offer potential opportunities for healthcare providers and related organizations to complement their services and improve health outcomes by coordinating and managing care for patients with chronic conditions under outcome-based payment structures. These programs may be particularly attractive if an organization can build upon existing care management and technology infrastructure and expertise, such as experience providing remote physiologic monitoring, remote therapeutic monitoring, chronic care management, advanced primary care management, similar services or other technology-based approaches to effectively manage health conditions.
