# The promise and uncertainty of Medicare's ACCESS model

## TL;DR

Medicare's ACCESS model aims to improve chronic disease care through new payment methods, but its success depends on unresolved details.

## Contribution

The paper introduces and analyzes the novel ACCESS payment model for chronic disease management in Medicare.

## Key findings

- ACCESS offers recurring payments tied to clinical improvement rather than discrete encounters.
- The model's success depends on unresolved issues like payment levels and quality measurement.

## Abstract

CMS's new ACCESS payment model is a novel approach in how Medicare pays for chronic-disease management: recurring, condition-specific payments tied to clinical improvement, rather than billing for discrete encounters or tightly defined remote-monitoring activities. The promise is straightforward, more reimbursement for technology-enabled longitudinal care and more choice and competition for patient care. But ACCESS leaves many questions unanswered about payment levels, how quality is measured, risk adjusted, and how these patients' facing technology-enabled services coordinate care with the traditional delivery systems. Whether ACCESS strengthens primary care will depend on the details.