The CMS ACCESS Model (Advancing Chronic Care with Effective, Scalable Solutions) is a 10-year CMS Innovation Center model that pays for technology-supported chronic care in Original Medicare on an outcome-aligned basis. It is open to Medicare Part B–enrolled organizations with a Medicare-enrolled Medical Director. Integral Healthcare Solutions (IHS) offers this service to clinician-led digital-care organizations entering Medicare or preparing for a later cohort: IHS builds the ACCESS policy package, enrollment workflow and reporting map; your Medical Director owns the care, and your team applies.

What is the ACCESS Model?

CMS describes the model this way: “The ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model tests an outcome-aligned payment approach in Original Medicare to expand access to new technology-supported care options that help people improve their health and prevent and manage chronic disease” (CMS ACCESS Model page). The same page says “It runs for 10 years and began July 5, 2026.”

The governing documents are the ACCESS Model Request for Applications (RFA), a 63-page document issued under Section 1115A of the Social Security Act, and the ACCESS Participation Agreement. The Participation Agreement is not public; the RFA says that “If selected, applicants will be required to execute a Participation Agreement with CMS.” CMS also publishes companion material for the model, including detailed FAQs, billing guidelines for Outcome-Aligned Payments (OAP) and an API implementation guide. This page is built from the model page and the RFA.

ACCESS changes how a participant bills for aligned patients. The model page states: “ACCESS Participants and their affiliated entities may not submit Medicare Fee-For-Service (FFS) claims (directly, or indirectly through another organization for which they provide contracted services) for other services furnished to their ACCESS-aligned beneficiaries during an active care period.”

Who needs it and what triggers it

Eligibility is set on the model page: “ACCESS participants must be Medicare Part B–enrolled organizations (excluding Durable Medical Equipment, Prosthetics, Orthotics, and Supplies and laboratory suppliers) and designate a Medicare-enrolled Medical Director to oversee care quality and compliance.” The RFA adds that “The Medical Director must be a Doctor of Medicine or Osteopathy who is an employee or is under contract with the Participant.”

CMS's model page uses both terms: it says organizations designate a Medicare-enrolled Medical Director in one place and a physician Clinical Director in others. The RFA uses Medical Director and requires a Doctor of Medicine or Osteopathy who is an employee of or under contract with the participant. IHS follows the RFA.

The usual triggers are:

• A cohort date. The RFA says “Applications will be accepted on a rolling basis from the release of this RFA through April 1, 2033” (p. 12), with “Subsequent Cohorts Begin January 1, 2027, and quarterly thereafter through July 1, 2033” (Table 2). It tied the January 1, 2027 cohort to applications received before October 1, 2026; that date had passed by this page's review date (October 2, 2026). The research pages do not state the current cohort deadline, so read the CMS model page for it.
• A new clinical track. The model page states: “New tracks for heart failure, chronic obstructive pulmonary disease (COPD), substance use disorder, tobacco cessation, and chronic musculoskeletal (MSK) pain (follow-on period) start April 1, 2027.”
• Selection. An organization that has been selected must execute the Participation Agreement and then operate to its terms. The RFA is direct that “Not all applicants will be accepted into the ACCESS Model.”

How IHS helps

IHS treats ACCESS as a program build. The work runs in this order:

1. Readiness dependency map. IHS reads the RFA and the model documents you hold and maps each participation obligation to the steps it depends on.
2. Questionnaires and crosswalk. IHS sends questionnaires on your clinical model, enrollment, data and vendors, then crosswalks each obligation to an owner in your organization and the evidence that shows it is met.
3. Drafting. IHS drafts the governance and policy package, including the clinical policies and the written patient safety plan for your Medical Director to review and approve, an enrollment workflow, a reporting ownership matrix and a vendor acceptance checklist.
4. Mock review. IHS reviews the package against the participation terms the way a reviewer would and lists what is missing.
5. Application support. IHS drafts application text. Your organization reviews it and submits it to CMS.

What you supply: your clinical model, your Medical Director, your technology stack, your finance model and the facts that establish eligibility.

The limit: eligibility, measures and payment economics need checks by your finance and engineering teams; IHS does not model your payments or build your API connection. The care belongs to your Medical Director and clinicians. IHS drafts clinical policy for them to approve and does not set clinical standards.

What to have ready

Each item below ties to the ACCESS RFA or the ACCESS model page as they read in October 2026.

• Your Medicare Part B enrollment for the applying organization, and confirmation it is not a DMEPOS or laboratory supplier enrollment (model page eligibility statement).
• The name of your Medical Director, evidence that he or she is a Doctor of Medicine or Osteopathy, and the employment or contract document (RFA).
• Your current clinical policies and procedures for the care you plan to deliver under ACCESS. The RFA has the Medical Director “Participate in the development, periodic review and approval of the Participant's clinical policies and procedures for ACCESS care”.
• Any existing patient safety plan, since the same RFA passage requires “a documented written patient safety plan”.
• A named owner and system for submitting outcome measures, since participants must “Submit OAP Measures via CMS' FHIR®-based API” (RFA, ongoing participation criteria).
• A list of every way you or an affiliated or contracted organization now bills Medicare fee-for-service for patients who could be aligned to you (model page FFS statement quoted above).
• The cohort start date you are aiming for, checked against RFA Table 2.
• Which tracks your clinical model fits, including whether you are waiting for a track that starts April 1, 2027 (model page).
• The person who will sign the Participation Agreement and the counsel who will review it (RFA).

Bring whatever you have to the introductory call; the gaps are what the readiness map is built to close.

How it compares

CMS's own FAQ on the model page places ACCESS next to three other arrangements. The table quotes CMS and does not rank them.

The choice turns on your patient population, how you bill today and the FFS restriction during an active care period. Your finance team and counsel make that call.

What it costs

CMS does not publish a fee schedule on the pages we reviewed; fees depend on scope. No application fee appears on the model page or in the RFA sections we read. CMS publishes model payment amounts and performance targets in a separate document, which this page does not summarize. IHS scopes each engagement after a free introductory call.

What this is not

• It is not legal advice. Participation Agreement terms and billing questions go to your counsel.
• It is not a guarantee of selection. CMS decides which applicants it accepts.
• IHS does not submit your application or deal with CMS for you. IHS drafts; your organization submits.

Frequently asked questions

What is the CMS ACCESS Model?

ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) is a CMS Innovation Center model that tests an outcome-aligned payment approach in Original Medicare for technology-supported care that helps people prevent and manage chronic disease. CMS says it runs for 10 years and began July 5, 2026. It is governed by the Request for Applications and a Participation Agreement that each selected organization signs.

Who is eligible to participate in ACCESS?

Participants must be Medicare Part B-enrolled organizations, excluding DMEPOS and laboratory suppliers, and must designate a Medicare-enrolled Medical Director. The RFA requires the Medical Director to be a Doctor of Medicine or Osteopathy who is an employee of, or under contract with, the participant.

When is the next ACCESS application deadline and cohort start date?

The RFA accepts applications on a rolling basis through April 1, 2033. Cohorts begin January 1, 2027 and quarterly after that through July 1, 2033. The RFA tied the January 1, 2027 cohort to applications received before October 1, 2026; that date had passed by this page's review date (October 2, 2026). The research pages do not state the current cohort deadline, so read the CMS model page for it.

How do Outcome-Aligned Payments work in ACCESS?

CMS describes ACCESS as an outcome-aligned payment approach and contrasts it with traditional fee-for-service, where payments are tied to specific activities or devices. Participants report OAP Measures to CMS through a FHIR-based API. CMS publishes the payment amounts and performance targets in separate documents, which your finance team should model before you apply.

What clinical tracks does ACCESS cover, and what starts April 1, 2027?

CMS states on the ACCESS model page that new tracks for heart failure, COPD, substance use disorder, tobacco cessation, and chronic musculoskeletal pain (follow-on period) start April 1, 2027. Check the model page for the tracks open to the cohort you are aiming for.

What policies and patient safety plan does an ACCESS participant need?

The RFA has the Medical Director participate in the development, periodic review and approval of the participant's clinical policies and procedures for ACCESS care, including a documented written patient safety plan. IHS drafts these documents for the Medical Director to review and approve.

What are the ACCESS health IT and reporting requirements?

The RFA lists submitting OAP Measures via CMS' FHIR-based API among the ongoing participation criteria. IHS builds a reporting ownership matrix that names who owns each measure and submission; your engineering team builds and tests the connection.

Can an ACCESS participant still bill fee-for-service for aligned patients?

Not for other services during an active care period. CMS states that participants and their affiliated entities may not submit Medicare FFS claims, directly or through another organization for which they provide contracted services, for other services furnished to their ACCESS-aligned beneficiaries during an active care period.

How does ACCESS interact with ACOs and Medicare Advantage?

CMS says ACCESS complements ACO and other risk-bearing arrangements. It also says Medicare Advantage organizations may independently adopt similar outcome-aligned payment arrangements with their contracted providers. Your contracts with ACOs and MA plans should be reviewed by counsel before you apply.