ACCESS — Advancing Chronic Care with Effective, Scalable Solutions — is a voluntary CMS Innovation Center model announced launching July 5th. It tests a new payment lane in Original Medicare (not Medicare Advantage) for technology-supported management of chronic disease.

Is this a new way that physicians are getting paid? We’ll explore what this means for physicians below.

ACCESS targets four clinical tracks that hit more than two-thirds of Medicare beneficiaries:

The word that matters here is voluntary.

Patients have the option to sign up directly with a participating organization, keep every Original Medicare right they had, and can still see any doctor they want. This is an opt-in side door, not a restructuring of how Medicare pays everyone.

We recently made a video on ACCESS that led to a controversial comment section.

Traditional fee-for-service pays you for a thing you did: a patient visit, a procedure code, etc.

ACCESS pays an Outcome-Aligned Payment (OAP): a recurring monthly amount per patient per condition, where full payment depends on whether the patient actually hits a clinical target. Think "lower this patient's blood pressure by 10 mmHg” instead of "you billed a chronic care management code this month."

CMS doesn't pay per individual success. It scales your payment to the share of your patients who hit their outcome targets, measured against a minimum threshold that ratchets up every year you're in the model. Perform well across your panel and you collect; let the patient cohort drift and the reimbursement shrinks.

Per a March analysis, the payment rates land around $7.50 to $35 per beneficiary per month depending on the track. That's pretty modest, and it's lower than fee-for-service for comparable work. Medications, labs, imaging, and DME are explicitly carved out and still bill separately.

The piece most physicians are missing: if you're a PCP or referring clinician, you don't have to participate to benefit. You can refer a patient to an ACCESS organization, get electronic progress updates back, and bill a new co-management payment for documented review of those updates plus coordination work — medication adjustments, problem-list updates, that kind of thing.

So it’s potentially new money for something close to what good PCPs already do informally. It’s probably the most relevant change for a working physician.