A wellness app just enrolled your Medicare patient with chronic kidney disease into a care program you have never seen. Their care plan is being managed outside your practice. Under the new CMS ACCESS model, that relationship could be locked in for the next 10 years.
A New CMS Program, and a Race to Claim Your Patients
On July 5, 2026, the Centers for Medicare and Medicaid Services launched the ACCESS model: a 10-year program that pays healthcare organizations to actively manage Medicare patients with chronic conditions like kidney disease, heart failure, and diabetes between their regular doctor visits.
The idea is straightforward: keep high-risk patients healthier in the gaps between appointments, reduce hospitalizations, and get paid for doing it.
What makes it complicated is who else showed up. A significant number of organizations have already enrolled as ACCESS participants, including consumer wellness companies with no prior clinical relationship to your patients but with fast-moving enrollment operations. Once a patient signs up with any one of them, CMS does not allow that patient to be re-enrolled by another program. That lock-in runs for the life of the program.
Every week you wait is a smaller eligible pool.
What This Actually Means for Your Practice's Bottom Line
The financial opportunity under ACCESS comes from three places, and none of them require changing how your practice operates today.
A new co-management fee. CMS will pay approximately $100 per patient per year to referring providers for actively reviewing and coordinating care for enrolled patients. That fee is billed directly by your providers and sits on top of everything you already earn.
Your existing billing, untouched. This is the question every practice asks first. When Innovaccer operates as the ACCESS participant through Story Health Partners, its physician entity, the CMS billing restrictions apply to Innovaccer, not to your practice. Every office visit, specialist referral, lab, and procedure your team bills today continues at the same rates.
More patients returning in-network. When patients are managed proactively, they show up for scheduled appointments instead of the emergency room. Practices on Innovaccer's platform have seen measurable reductions in referral leakage as care management closes gaps before they become acute events.
The Clinical Risk Nobody Is Talking About
Most of the conversation about ACCESS focuses on the revenue opportunity. The risk to your patients deserves equal attention.
When someone managing heart failure or advanced kidney disease enrolls with a consumer health app, their care will not pause. It will continue somewhere else. Medication changes will happen. Care plans will get updated. Referrals will go out. Your practice may find out weeks later, or not at all.
This will happen to your highest-acuity Medicare patients, at the exact moment they need the most coordinated care.
Innovaccer's model is built around keeping that clinical relationship with you. Every decision made about your patient, including every medication adjustment, care plan update, and escalation, flows directly back to your providers through your existing EHR. Your team sees what is happening with your patients in real time, even between appointments.
The care itself adapts to each person individually. Innovaccer uses Adaptive Program Intelligence™: a system that adjusts how closely a patient is monitored based on how they are actually responding, not a one-size protocol applied to everyone. Patients who are engaging and improving stay at a lighter level of support. Patients trending in the wrong direction get more active intervention automatically.
The financial consequence of the wrong partner is not a missed feature. It is referrals that stop returning, clinical decisions your team cannot see, and a revenue model built on someone else's relationship with your patients.
Frequently Asked Questions
Do I need new technology or a long implementation to get started? For practices already on Innovaccer's platform, ACCESS is a contract extension: no new system, no IT project. For new practices, Innovaccer connects to a broad range of EHR systems and is typically active within weeks.
Will this add more work for my staff? Your care team's workload will decrease, not increase. Innovaccer's team runs the day-to-day care management program. Your coordinators have full clinical visibility into what is happening, without a new list of tasks to manage.
What if our enrolled patients don't hit their health targets? Your co-management revenue and FFS billing are not tied to patient outcomes. Innovaccer absorbs that accountability entirely through the Story Health Partners structure. Your practice has no financial exposure if performance benchmarks are not met.
Is it too late to join if we haven't enrolled yet? The program launched on July 5, and enrollment is ongoing. What changes over time is how many of your patients will still be available. Every day since launch, patients are being enrolled by other participants and locked out of your program. Earlier action means a larger eligible population.
Which patients qualify? Medicare patients managing chronic kidney disease, heart failure, and type 2 diabetes qualify under the Early CKM and Advanced CKM tracks now that the program has launched. Additional conditions are in development; confirm current track availability with the Innovaccer team before communicating this to patients.
Find out how many of your Medicare patients will qualify for ACCESS.
Book a 30-minute population review with Innovaccer's ACCESS team. We will map your eligible patients by condition, model co-management revenue for your specific practice, and walk through exactly how the program works. No commitment required.
