The Medicare ACCESS model will reach 165 million more Americans in other payer markets by 2028, according to an announcement by the Centers for Medicare and Medicaid Services on Thursday.
While the initial ACCESS model would allow Medicare beneficiaries to benefit from health technology for the treatment and management of chronic conditions, other healthcare payers have now signed onto a pledge that would expand the model to the Medicare Advantage, Medicaid and commercial markets.
The voluntary model focuses on conditions affecting more than two-thirds of people with Medicare, including high blood pressure, diabetes, chronic musculoskeletal pain and depression. It will help pay for telehealth software, wearables and wellness apps that address the conditions.
Now, commercial payers are agreeing to make arrangements with providers that will provide consistent, outcome-aligned payments for the use of healthcare technology. The plans also agreed to work with primary care and referring providers, a hallmark of the CMMI ACCESS model.
Payers that have signed the pledge include Arkansas Blue Cross and Blue Shield, Blue Shield of California, Blue Cross and Blue Shield of Minnesota, Blue Cross Blue Shield of North Dakota, BlueCross BlueShield of Tennessee, CareFirst BlueCross BlueShield, Centene, Cigna, CVS Health, Devoted Health, Guidewell, Horizon Blue Cross Blue Shield of NJ, Humana and UnitedHealthcare.
The Centers for Medicaid and Medicare Innovation (CMMI) announced the ACCESS model on Dec. 1. The 10-year program will allow Medicare beneficiaries to use health technology solutions to address chronic conditions. The model will reward outcomes through Outcome Aligned Payments, a new type of payment program designed for the model.
The ACCESS reporting period begins on July 5, 2026 and lasts for 10 years. Interested parties must declare to CMS by April 1, 2026 to begin on July 5.
The CMS also announced it is developing reference materials for payers such as: sample provider agreement structure and payment adjustment code, standardized billing codes, including track-specific G-codes that may be used by any payer to support consistent administrative workflows and a FHIR-based reporting infrastructure, according to a press release by the CMS.
“When CMS and employers work with providers to deliver care with these reforms at-scale, it will make a meaningful difference in the cost and quality of care, the health of employees and their families, and engagement with the health care system for all Americans,” the Business Group on Health wrote in a statement.
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