A plain-language breakdown of what this model requires, what it rewards, and where patient engagement becomes the make-or-break variable.
A new Centers for Medicare & Medicaid Services (CMS) model launches July 5, 2026. If you lead an Accountable Care Organization (ACO), run population health for a health system, or operate inside a value-based care arrangement, the ACCESS Model — Advancing Chronic Care with Effective, Scalable Solutions — deserves your attention.
What Is the CMS ACCESS Model?
The ACCESS Model is a voluntary, 10-year CMS Innovation Center model that pays participating organizations based on measurable clinical outcomes across four tracks: early cardio-kidney-metabolic (eCKM), cardio-kidney-metabolic (CKM), musculoskeletal (MSK), and behavioral health (BH). Payment rates reach up to $35 per beneficiary per month depending on the clinical track — structured as Outcome-Aligned Payments (OAPs) rather than traditional fee-for-service (FFS) codes. That translates to roughly $180–$420 per patient per year, with 50% withheld until outcomes are demonstrated.
For referring primary care physicians (PCPs), there’s a new incentive built in: a co-management payment that allows PCPs to bill for documented review and coordination activities — up to $30 every four months, or $100 per year per patient. It’s designed to keep primary care in the loop and drive patient engagement into the model.
For ACOs specifically, ACCESS costs do not affect Medicare total cost of care calculations for the first 12 months.
The Shift That Matters Most: Outcomes Over Activity
Most value-based programs have still rewarded activity — visits completed, codes submitted, programs enrolled. ACCESS shifts that dynamic. Payment is tied directly to whether patients actually improve against condition-specific clinical targets. Miss the benchmark, and 50% of payment is lost. Enrolling a patient is just the beginning. For ACOs and population health operators, this formalizes familiar pressure in a new way and rewards organizations who have already built the real engagement infrastructure.
What Makes or Breaks Performance
Unlike every ACO model before it, ACCESS allows patients to enroll directly — without claims-based attribution or physician assignment. That makes patient engagement a front-end function. The organizations that win under ACCESS won’t just have strong clinical protocols — they’ll have the outreach infrastructure, real-time data visibility, and follow-through mechanisms to reach the right patients, get them enrolled, and keep them engaged long enough to move the needle.
Key Takeaways
- ACCESS launches July 5, 2026 — a voluntary, 10-year CMS model that pays on outcomes, not activity.
- Payment is contingent on results — up to $35 PBPM across four clinical tracks, with 50% withheld until outcome thresholds are met.
- Enrollment is not enough — consistent patient engagement after enrollment determines whether the program pays.
- ACCESS allows direct patient enrollment without claims-based attribution, making proactive outreach a front-end requirement, not an afterthought.
The Bottom Line
ACCESS rewards organizations that already treat patient engagement as a clinical function — not a marketing afterthought. The payment model is generous for those that perform. It is unforgiving for those that don’t.
Avery Telehealth partners with ACOs, health systems, and value-based care organizations to execute the clinical programs ACCESS rewards — Annual Wellness Visits (AWVs), Transitional Care Management (TCM), high-risk case management and proactive patient outreach built on real-time data. Want to talk through what ACCESS readiness looks like for your organization?
Read our announcement on Avery Telehealth’s selection as an ACCESS Model participant.