ACCESS Program Gives Outcomes-Based Payment for Tech-Forward Chronic Care

Healthcare attorney Becca Waltuch was quoted in a Part B News article about a new Centers for Medicare & Medicaid Services (CMS) program aiming to expand options for managing chronic conditions through technology-enabled care. Under the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) model created by the Center for Medicare and Medicaid Innovation (CMMI), participants will operate with an outcome-aligned payments (OAP) approach instead of the traditional fee-for-service (FFS) setup. ACCESS will issue quarterly payments based on improved clinical results for patients with conditions such as early cardio-kidney-metabolic (eCKM) diseases and behavioral disorders. Professionals interviewed by Part B News highlighted that although value-based payment arrangements like ACCESS are not new for CMS or CMMI, the focus on technology is, opening opportunities for tech vendors with medical offerings. Ms. Waltuch clarified that even though the OAPs cover patient care and treatment, not the tools used toward that end, providers will still have to describe how they are employing technology to advance results.

"CMS has indicated the ACCESS model is designed to fund use of technology-enabled care to support care management via, for example, remote monitoring and digital therapeutics," she said. "These services have historically been difficult to reimburse or have not been reimbursed under traditional Medicare. Therefore, the goal of ACCESS is that participants will invest in their technology infrastructure or identify technology partners, because these participants are getting paid for care management and achievement of outcomes that will be supported by use of such technology."

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