CMS has released the payment amounts and performance targets for its new voluntary ACCESS model – a condition-based, outcomes-driven payment approach that could reshape how chronic care is delivered in Original Medicare. With annual payments ranging from $180 to $420 depending on the clinical track, the model blends predictable per-member per-month revenue with performance risk tied to clinical and patient-reported outcomes.
The rates and guardrails are already prompting tough questions from providers, digital health companies, and other stakeholders about scalability, financial risk, and operational feasibility. From flat payments that do not adjust for acuity to strict reporting requirements and fee-for-service exclusions, ACCESS presents both opportunity and exposure. Our latest +Insight breaks down what CMS finalized, where the pressure points are, and what stakeholders should be weighing as they consider participation.
