Senior living providers and their partners have until this Wednesday, April 1, to submit an application for CMS’s new payment model, ACCESS (Advancing Chronic Care with Effective, Scalable Solutions). Applications received after this date will be considered for a January 1, 2027 start.
The model is a 10-year voluntary Medicare program that incentivizes organizations for improving outcomes in chronic care patients instead of billing per service. It promotes expanded use of technology like telehealth, wearables, digital coaching, and remote monitoring to supplement routine clinician visits. ACCESS may offer opportunities to build care partnerships and electronic referrals, adopt and realize ROI on technology, and align with pilot programs and technology-enabled prevention. Participating organizations receive “Outcome-Aligned Payments” (OAPs) for managing chronic conditions, with payments tied to achieving measurable health improvements.
ACCESS initially targets four condition tracks covering about two-thirds of Medicare beneficiaries:
- Early Cardio-Kidney-Metabolic (eCKM): Hypertension, dyslipidemia, obesity/overweight, prediabetes
- Cardio-Kidney-Metabolic (CKM): Diabetes, CKD, atherosclerotic cardiovascular disease
- Musculoskeletal (MSK): Chronic musculoskeletal pain
- Behavioral Health (BH): Depression and anxiety
Eligible organizations must be Medicare Part B–enrolled providers, have a designated physician Clinical Director, comply with federal/state licensure and HIPAA/FDA rules, and be capable of electronic care-plan sharing and HIE connectivity for coordination. Medicare beneficiaries can enroll directly or via clinician referral, and CMS will maintain a public directory of participants and their risk-adjusted outcomes. Organizations will receive recurring, predictable Outcome-Aligned Payments (OAPs) for longitudinal, tech-enabled care. Full payment depends on demonstrated improvements from baseline in outcome measures (such as reduced blood pressure or improved HbA1c).
To be considered for the model’s first performance period beginning July 5, 2026, senior living operators and industry partners must submit applications by April 1, 2026 through the Participant Portal. Applications received after this date will be considered for the next cohort beginning in January 2027. The model runs through June 30, 2036.