Chronic Care · CMS Policy · Remote Patient Monitoring
On July 5, 2026, CMS opened its ACCESS Model (Advancing Chronic Care with Effective, Scalable Solutions), a 10-year, voluntary payment program built to move Medicare reimbursement away from rewarding activity and toward rewarding results. For practices that already run remote patient monitoring (RPM) and chronic care management, the message is direct: chronic care has to reach patients in the weeks between visits, not just inside the exam room. The devices, data, and clinical routines that RPM and CCM programs already depend on now sit squarely in the path of how Medicare intends to pay for chronic care.
What the CMS ACCESS Model Is
ACCESS, short for Advancing Chronic Care with Effective, Scalable Solutions, is run by the CMS Innovation Center (CMMI) under Section 1115A authority and operates from July 5, 2026 to June 30, 2036. Participation is optional, open to Medicare Part B-enrolled providers and suppliers, and accepted on a rolling basis through 2033.
What changes most is the payment logic itself. Traditional Medicare fee-for-service pays for things that happen, minutes logged, devices issued, encounters recorded. ACCESS pays a recurring Outcome-Aligned Payment (OAP) that hinges on whether patients actually get better. In year one, earning the full payment means at least half of enrolled patients have to hit guideline-based clinical targets, such as a set drop in blood pressure or HbA1c. The bar rises every year that follows.
ACCESS is a brand-new, standalone model. It does not extend RPM, CCM, or APCM, and it does not take their place. Organizations can keep billing the care management CPT codes they use today.
ACCESS simply adds another route, one with a different payment structure for organizations that decide to opt in.
The Four Chronic Condition Tracks
ACCESS targets conditions that touch more than two-thirds of Medicare beneficiaries. Every track carries its own defined outcome measures, and those measures decide whether a participating organization earns full payment.
Early Cardio-Kidney-Metabolic (eCKM)
Hypertension, dyslipidemia, obesity with central adiposity, and prediabetes. Outcomes: control of blood pressure, lipids, and weight.
Cardio-Kidney-Metabolic (CKM)
Diabetes, CKD stage 3a/3b, and atherosclerotic cardiovascular disease. Outcomes: HbA1c, BP, lipids, eGFR, and UACR.
Musculoskeletal (MSK)
Chronic musculoskeletal pain. Outcomes: gains in pain intensity, interference, and function measured with validated PRO tools.
Behavioral Health
Depression and anxiety. Outcomes: improvement on PHQ and GAD-7, plus the WHO Disability Assessment Schedule for overall function.
Within their chosen track, participants take responsibility for managing all of the qualifying conditions. Most tracks pair an initial period of care with an optional continuation period at a lower payment rate, an acknowledgment that the resources a patient needs tend to ease once their care stabilizes. The MSK track is the exception and has no continuation period.
How ACCESS Compares to RPM, CCM, and APCM
ACCESS rewards the same idea that drives RPM and CCM, steady, between-visit support, but runs on a completely different payment engine. Getting that difference straight matters when you’re weighing whether, and how, to take part.
| Program | Payment basis | What it pays for | FQHCs/RHCs eligible |
|---|---|---|---|
| RPM | Fee-for-service CPT codes | Device supply and monitoring time | Yes (since 2025) |
| CCM | Fee-for-service CPT codes | Documented care coordination time | Yes |
| APCM | Fee-for-service HCPCS codes | Monthly service bundle by complexity tier | Yes |
| ACCESS | Outcome-aligned payments (OAPs) | Measurable patient improvement at population level | Part B enrollment required |
RPM reimburses the work of remote monitoring and device-based data transmission. ACCESS pays for none of that activity on its own, it pays for improvement.
Because ACCESS, RPM, and CCM are separate Medicare programs, practices can keep billing RPM and CCM while also participating in ACCESS. Patients enrolled in ACCESS draw Outcome-Aligned Payments through the model, and providers can bill co-management codes when a referring clinician coordinates care with an ACCESS participant.
What Practice Readiness Looks Like for ACCESS
ACCESS doesn’t mandate any one technology. What it demands is proof that patients are getting better. In practice, that makes a strong ACCESS program look a lot like a well-run RPM or CCM program already does: connected devices, structured workflows, patient engagement between visits, and outcome tracking over time.
Organizations with mature RPM and CCM workflows are already partway to ACCESS readiness. The digital backbone, connected devices, care management workflows, patient engagement tools, and outcome tracking, overlaps heavily with what ACCESS asks for.
The operational pieces that most directly support ACCESS participation include:
- Patient-level outcome tracking measured against clinical baselines across the full chronic disease panel.
- Continuous physiologic data capture from connected devices, blood pressure monitors, glucometers, and weight scales among them.
- Monthly clinical summaries shared electronically with referring and co-managing providers.
- Structured care team workflows that react to data trends instead of waiting for the next scheduled visit.
- Patient engagement tools that keep patients active between appointments, not only during them.
- Documentation that cleanly separates ACCESS clinical work from RPM or CCM billing wherever both programs run side by side.
For practices that haven’t built this infrastructure yet, ACCESS is a clear prompt to begin. The rolling application window stays open through 2033 and includes a January 1, 2027 cohort entry point for organizations that missed the first deadline.
How DrKumo Supports Continuous Chronic Care
DrKumo delivers HIPAA-compliant, FIPS-compliant digital health technology built for exactly the kind of continuous, between-visit care ACCESS is organized around. The platform moves physiologic data from patients’ homes to care teams over cellular connectivity, no Wi-Fi or smartphone app required, which makes it workable for the chronic disease populations ACCESS targets, including patients in rural communities and those cared for by FQHCs and RHCs.
It also ships with evidence-based Disease Management Protocols (DMPs) for the chronic conditions that recur across all four ACCESS tracks: hypertension, diabetes, heart failure, and COPD. For community providers weighing how a comprehensive RPM program fits their chronic care strategy, DrKumo can offer context on how these programs work alongside evolving CMS payment models.
DrKumo is not a clinical entity and does not provide clinical services. Providers retain full clinical responsibility for patient care decisions.
Key Takeaways
The CMS ACCESS Model launched July 5, 2026 as a 10-year voluntary Medicare payment program. Its Outcome-Aligned Payments reimburse participating organizations based on whether patients with chronic conditions actually improve, not on the specific services rendered or the time logged.
ACCESS does not replace RPM, CCM, or APCM. Those remain separate Medicare billing pathways. ACCESS layers on an additional model for organizations that opt in, with a fundamentally different, outcome-based payment structure.
Its four clinical tracks span the most common Medicare chronic conditions: early and established cardio-kidney-metabolic disease, chronic musculoskeletal pain, and behavioral health. Organizations already delivering technology-supported chronic care will find substantial operational overlap with what ACCESS requires.
Readiness comes down to the same foundation that makes RPM and CCM work well: connected devices, structured care team workflows, continuous patient engagement, and longitudinal outcome tracking. Building that foundation now prepares a practice not just for ACCESS, but for whatever comes next in Medicare chronic care payment.
Data-driven care starts here
Build the chronic care infrastructure ACCESS requires.
To learn how DrKumo can help your organization deliver secure, continuous remote patient monitoring aligned with evolving CMS care models, contact us today. Our team is ready to support your journey toward better patient care.
Frequently Asked Questions
Common questions about the CMS ACCESS Model and what it means for chronic care programs.
References
- Centers for Medicare and Medicaid Services. (2026). ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model. CMS.gov.
- Centers for Medicare and Medicaid Services. (2026). ACCESS Technical Frequently Asked Questions. CMS.gov.
- ArentFox Schiff. (2026). CMS Innovation Center Unveils ACCESS Model to Expand Technology-Supported Care for Chronic Disease. AFS Law.
- Manatt, Phelps and Phillips. (2025). ACCESS Unlocked: CMS’s Bold New Model for Tech-Enabled Chronic Care Management. Manatt.com.
