CMS ACCESS Is Coming: How Health Systems Can Win the Next Era of Chronic Care With Validic
Health systems that begin planning now will capture the full ACCESS payment opportunity, outperform peers in public reporting, and modernize their chronic-care infrastructure.
The Centers for Medicare & Medicaid Services (CMS) launched the ACCESS Model (Advancing Chronic Care with Effective, Scalable Solutions), a 10-year Innovation Center payment model designed to reward continuous, outcomes-driven care for chronic conditions. ACCESS represents more than a new reimbursement program; it signals CMS’s clearest move yet toward technology-enabled, population-scale management of chronic diseases.
For health systems, ACCESS creates a rare combination: predictable revenue, flexibility in care delivery, and public visibility into performance. But it also raises the bar operationally. Success will depend on whether organizations can deliver measurable improvement across thousands of patients—without overwhelming clinicians.
What Is the CMS ACCESS Model?
ACCESS provides recurring payments to organizations that manage chronic conditions for patients with Original Medicare, including hypertension, diabetes, heart failure–related risks, depression and anxiety, and chronic musculoskeletal pain. Unlike fee-for-service models, ACCESS ties payment directly to outcomes. Organizations earn full payment only when meaningful clinical improvement (such as blood pressure control or improved glycemic outcomes) is demonstrated.
Additionally, ACCESS removes many of the structural barriers that have historically slowed digital and remote care adoption:
Flexibility to use virtual care, asynchronous care, connected devices, and remote monitoring
No per-touch CPT billing requirements for individual interactions
Waived beneficiary copays for ACCESS-covered services
At the same time, CMS will publish ACCESS performance data in a public directory, making chronic-care outcomes a visible differentiator for patients, payers, and partners.
Why ACCESS Demands Action Now, Not in 2026
Although the program officially launches in mid-2026, the work required to succeed under ACCESS must begin much earlier.
ACCESS Unlocks a New Chronic-Care Revenue Stream
Hypertension, diabetes, heart failure, and behavioral health conditions account for a disproportionate share of Medicare utilization and cost. ACCESS will pay health systems to manage these conditions continuously rather than episodically. For large systems, this represents a significant, recurring revenue opportunity directly aligned with chronic disease performance.
Operational Readiness Will Separate Leaders from Laggards
ACCESS success depends on capabilities that are difficult to stand up quickly:
Continuous patient-generated health data at population scale
Team-based care models that span nurses, pharmacists, care managers, and physicians
Longitudinal outcome tracking across thousands of patients
EHR-native workflows that reduce clinician burden rather than add to it
Organizations that wait until the applications open to design workflows, staffing models, and data infrastructure may struggle to earn full ACCESS payments.
ACCESS requires an application, with submissions due in April 2026. Health systems that intend to participate are already evaluating technology partners, modeling financial impact, and designing care programs.
The Strategic Role of Health Systems in ACCESS
Large, integrated health systems that already participate in value-based care models are likely to deliver ACCESS programs directly, maintaining control over care delivery, patient experience, and revenue. Community systems and provider groups may consider partnering or outsourcing components of the program.
In every scenario, the ability to deliver scalable, measurable, outcomes-driven chronic care will be decisive.
Where Validic Fits in the ACCESS Ecosystem
ACCESS requires health systems, medical groups, digital health and other organizations participating in Medicare Part B to operate chronic care programs at a scale and level of integration that traditional tools were not designed to support.
Validic provides the connected health data and workflow infrastructure that makes ACCESS operational. Our platform integrates patient-generated health data from a broad ecosystem of over 700 connected devices and applications and delivers it directly into EHR workflows.
With deep, EHR-native integrations, especially with Epic and Oracle Health, Validic enables clinicians to work entirely within the systems they already use, while our solution serves as the outside-the-hospital data and workflow engine.
Additionally, our generative AI capabilities summarize remote monitoring data, surface trends, and automate documentation, enabling care teams to manage large patient panels without increasing clinician burden.
How Validic Enables ACCESS Success
Scale Chronic Care Without Scaling Clinician Burden
ACCESS payments depend on outcomes, and outcomes depend on continuous engagement. Validic embeds monitoring workflows directly in the EHR, automates data ingestion, and applies AI-driven triage and summarization—enabling clinicians to manage large hypertension, diabetes, and heart failure populations efficiently.
Deliver Outcome-Grade Data for CMS Reporting
To earn full ACCESS payments, organizations must prove improvement. Validic structures blood pressure, glucose, weight, activity, and symptom data directly in the EHR, supporting baseline-versus-follow-up comparisons, longitudinal trends, and population-level reporting aligned with ACCESS performance metrics.
Reduce Patient Friction in Medicare Populations
Many ACCESS-eligible patients lack reliable Wi-Fi or smartphones. Through integrations with cellular-connected devices and gateways, Validic supports low-friction onboarding and reliable data transmission for rural, digitally limited, and high-risk Medicare beneficiaries.
Support Multiple ACCESS Conditions on a Single Platform
Validic supports monitoring for hypertension, diabetes, heart failure, obesity, activity, sleep, and behavioral health measures, allowing health systems to run multiple ACCESS tracks from a single unified infrastructure rather than managing a patchwork of point solutions.
Enable Team-Based Care Through Shared EHR Workflows
ACCESS is built around team-based care. Validic’s EHR-native approach enables nurses, pharmacists, care managers, physicians, and behavioral health clinicians to work from the same shared data and workflows, eliminating fragmented portals that limit scalability.
Winning Under ACCESS—and Beyond
ACCESS will reward health systems that can deliver technology-enabled chronic care with measurable outcomes at scale. If it is not embedded in the EHR, it will not scale. If it does not scale, it will not succeed under ACCESS.
Validic provides the remote care fabric that health systems need: device-to-dashboard connectivity, EHR-embedded workflows, and AI-driven efficiency.
The bottom line: ACCESS is approaching quickly. Health systems that begin preparing now will be best positioned to capture the full payment opportunity, stand out in public reporting, and lead the next era of chronic care innovation. Get ACCESS ready and talk to one of our experts to get started.