Act on ACCESS Now Before the Transition Reshapes Your Medicare Relationships

Earn referral revenue, protect FFS billing, and strengthen Medicare care relationships with Innovaccer's Population Health Operating System, built for continuous care, ready for ACCESS, and delivering outcome-focused care while absorbing outcome risk.
request a demo
request a demo
~$100
PMPY incremental
revenue with zero outcome risk
50%
OAP withhold captured
with AI-driven care delivery
Day 1
Fully operational,
no internal build required
What is CMS ACCESS?

A program designed for chronic care outcomes, not just visits

CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) is a 10-year CMMI model launching July 5, 2026. It introduces recurring revenue for organizations that use technology to measurably improve chronic disease outcomes. This is not an incremental billing code. It is a fundamentally new payment pathway that rewards results, not visits.
Hypertension
Diabetes
CKD
ASCVD
Chronic MSK Pain
Depression & Anxiety
Recurring, outcome-aligned payments
Payment tied to measurable clinical improvement - blood pressure reduction, HbA1c control, pain improvement, symptom reduction etc. Not volume, not number of visits, just results.
Technology-supported, continuous care
CMS explicitly mandates tech-enabled care - RPM, digital therapeutics, AI-driven coaching. Manual programs cannot break even under the ACCESS economics model.
Permanent voluntary patient alignment
Patients voluntarily align to one ACCESS Participant per track. Once aligned, they cannot re-align elsewhere. First-movers lock in their Medicare population.

Medicare is redirecting revenue. Be on the right side of it.

New Revenue, Zero New Infrastructure
ACCESS unlocks a recurring payment stream from Medicare patients already under active care. Innovaccer acts as the ACCESS Participant, while referring practices earn co-management revenue. No new contracts. No new overhead.
Protect Your Medicare Patient Base
Digital health companies are actively enrolling Medicare patients now. Care coordination authority, referral influence, and revenue are permanently lost once patients enroll with someone else. Secure the population before the window closes.
Ready from Day 1
ACCESS demands AI-enabled enrollment, longitudinal outcome tracking, and FHIR-integrated CMS reporting. Innovaccer delivers all of it, fully deployed and operational before the program launches. Practices show up ready.
End-to-End CMS ACCESS Infrastructure
From patient identification to CMS reconciliation
Turn medicare chronic care population into enrolled, managed, and measurably improved patients, with Innovaccer's outcome-focused managed program.
Identify & Stratify
Enroll at Scale
Monitor & Intervene
Track and Report Outcomes
Identify & Stratify
Surface risk early and activate the right patients, faster.
Unify clinical, claims, RPM, and PRO data into one longitudinal record, continuously scoring and assigning patients to the right ACCESS tracks, without operational overhead.
Enroll at Scale
Turn eligibility into enrolled medicare population
Activate automated multi-channel outreach across SMS, IVR, and email alongside EHR-embedded point-of-care referrals to enroll patients at scale.
Monitor & Intervene
Deliver smarter care during and between every visit
Monitor patients continuously, surface AI-driven risk alerts and clinical decisioning within EHR-native workflows, and extend care capacity with dedicated coach-led intervention for optimal outcomes.
Track and Report Outcomes
Hit performance targets and simplify CMS reporting
Track cohort performance through live dashboards, automate patient-reported outcome collection, and streamline payment reconciliation with FHIR-integrated CMS API submissions.
Two ways to participate
Close the gap between ACCESS readiness and revenue
Recommended
End-to-End Managed Program
Innovaccer manages the full ACCESS program - clinical delivery, patient enrollment, technology deployment, quality reporting, and outcome accountability. The organization earns co-management revenue with zero operational burden and zero downside risk.
Investment
Zero upfront capital
Risk
Zero downside exposure
Time to Value
Weeks, not months
Revenue
Referral while retaining
existing FFS billing
Platform License
The organization owns the ACCESS participation directly. Innovaccer provides the technology platform, implementation support, and analytics infrastructure. Clinical workflows, staff hiring, and outcome risk stay with the organization.
‍
Investment
Platform licensing fees
Risk
Complete risk ownership
Time to Value
Months, build required
Revenue
Full retention, full risk
request a demo
request a demo
Why Health Systems Choose Innovaccer
Built for scale. Proven in practice.
80M+
Patient lives connected through Innovaccer’s unified healthcare data platform, enabling providers, ACOs, and payers to activate data for better decisions and outcomes.
120+
Provider organizations operating on the Innovaccer platform today, including large health systems, ACOs, independent and specialty practices, managing millions of value-based lives.
60%
Reduction in heart failure hospitalizations delivered through StoryHealth, Innovaccer's AI-powered specialty care platform, proven at scale across Medicare populations.
#1
Population Health Platform top-ranked by Black Book. 90%+ across every KLAS category. Clinical performance, data integrity, and enterprise security - all independently verified
The only partner you need to succeed in CMS ACCESS
Your Medicare patients will receive technology-enabled chronic care. The only question is who delivers it.
request a demo
request a demo
FAQ

What is CMS ACCESS?
CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) is a 10-year CMMI model launching July 5, 2026 through June 30, 2036. It pays healthcare organizations monthly Outcome Achievement Payments (OAPs) tied to clinical targets for delivering longitudinal chronic care management to Medicare Fee-for-Service beneficiaries. Unlike traditional fee-for-service, ACCESS rewards measurable results — blood pressure reduction, HbA1c control, functional improvement — not visits or volume.
What chronic conditions does ACCESS cover?
ACCESS covers four clinical tracks. beneficiaries can be enrolled in multiple tracks simultaneously:
track
CONDITIONS
INITIAL PERIOD (PMPY)
FOLLOW-ON (PMPY)
Early Cardiometabolic (eCKM)
Hypertension, pre-diabetes, early-stage CKD
$360
$180
Cardiometabolic (CKM)
Diabetes, heart failure, CKD stage 3+, ASCVD
$420
$210
Musculoskeletal (MSK)
Chronic pain conditions
$180
No follow-on
Behavioral Health (BH)
Depression and anxiety
$180
$180
Early Cardiometabolic (eCKM)
conditions
Hypertension, pre-diabetes, early-stage CKD
INITIAL PERIOD (PMPY)
$360
INITIAL PERIOD (PMPY)
$360
Cardiometabolic (CKM)
conditions
Diabetes, heart failure, CKD stage 3+, ASCVD
INITIAL PERIOD (PMPY)
$420
INITIAL PERIOD (PMPY)
$210
Musculoskeletal (MSK)
conditions
Chronic pain conditions
INITIAL PERIOD (PMPY)
$180
INITIAL PERIOD (PMPY)
No follow-on
Behavioral Health (BH)
conditions
Depression and anxiety
INITIAL PERIOD (PMPY)
$180
INITIAL PERIOD (PMPY)
$90
Who is eligible to participate in ACCESS?
Eligible participants include health systems, physician groups, Accountable Care Organizations (ACOs), Federally Qualified Health Centers (FQHCs), and other Part B billing entities with Medicare Fee-for-Service beneficiary panels. Organizations can participate as a full ACCESS Participant or through a referral relationship with an established Participant.
What is the deadline to apply for CMS ACCESS?
Applications are accepted on a rolling basis. The first cohort deadline was April 1, 2026 for a July 2026 start. Subsequent cohorts can apply throughout the model duration, with new cohorts launching annually. Organizations targeting Q1 2027 participation should begin application preparation now.
Can my organization participate in ACCESS if we are already in MSSP?
Yes. MSSP ACOs can participate in ACCESS. For 2026-2027, ACCESS Outcome Achievement Payments are excluded from your ACO's benchmark calculation, providing an 18-month financial shield. Starting in 2028, ACCESS expenditures will be included in ACO benchmark calculations.
How does ACCESS payment work?
CMS pays monthly Outcome Achievement Payments (OAPs) — 50% upfront, 50% withheld pending outcome achievement. The Outcome Attainment Threshold (OAT) is the minimum percentage of enrolled beneficiaries who must achieve clinical targets to retain the full withheld amount. In Year 1, the OAT is 50%. If fewer beneficiaries hit targets, the withheld amount is reduced proportionally, up to a maximum 50% reduction.
track
INITIAL PERIOD RATE
FOLLOW-ON RATE
Early CKM
$30/month ($360/year)
$15/month ($180/year)
CKM
$35/month ($420/year)
$17.50/month ($210/year)
MSK
$15/month ($180/year)
—
BH
$15/month ($180/year)
$7.50/month ($90/year)
Early CKM
INITIAL PERIOD RATE
$30/month ($360/year)
FOLLOW-ON RATE
$15/month ($180/year)
CKM
INITIAL PERIOD RATE
$35/month ($420/year)
FOLLOW-ON RATE
$17.50/month ($210/year)
MSK
INITIAL PERIOD RATE
$15/month ($180/year)
FOLLOW-ON RATE
—
BH
INITIAL PERIOD RATE
$15/month ($180/year)
FOLLOW-ON RATE
$7.50/month ($90/year)
What are co-management payments in ACCESS?
Co-management payments compensate referring providers for reviewing and acting on clinical updates from the ACCESS Participant. ACCESS Model reimbursements are approximately $30 per service, with a $10 modifier for the initial onboarding visit. CMS compensates referring providers up to ~$100 per beneficiary per year through co-management billing, once every four months per track — while retaining their existing fee-for-service billing without new infrastructure or compliance obligations.
Why does ACCESS require technology-enabled care?
CMS explicitly mandates tech-enabled care delivery, including remote patient monitoring, digital therapeutics, and AI-driven coaching. Manual programs cannot break even under the ACCESS economics model — the payment structure is designed for scalable, technology-driven chronic care delivery.
Why does beneficiary alignment matter for first-movers?
Beneficiaries voluntarily align to one ACCESS Participant per track and cannot re-align elsewhere.
How does Story Health Partners support Referring Organizations in ACCESS?
Story Health Partners offers an end-to-end program where Story Health Partners manages clinical delivery, continuous monitoring, and outcome tracking that will be shared with the aligned beneficiary’s primary care provider.
How long does it take to launch an ACCESS program with Story Health Partners
Organizations that refer to Story Health Partners can launch ACCESS programs in 60-90 days through the managed program model, compared to 12-18 months for organizations building infrastructure to participate directly.
How is Story Health Partners different from competitors?
Proven outcomes with Story Health
We have already delivered results on outcome-based chronic care management — this is not new for us.
EHR-native workflows
Clinicians work inside their existing EHR, not a separate app, driving higher adoption.
Data + Intelligence + Delivery in one
Most vendors do one piece. We do all three — no stitching together multiple tools.
Data Stewardship
We enable unified intelligence while keeping your data silo-protected, access-governed, and shielded from external digital health platforms.
Proven outcomes with Story Health
We have already delivered results on outcome-based chronic care management — this is not new for us.
EHR-native workflows
Clinicians work inside their existing EHR, not a separate app, driving higher adoption.
Data + Intelligence + Delivery in one
Most vendors do one piece. We do all three — no stitching together multiple tools.
Data Stewardship
We enable unified intelligence while keeping your data silo-protected, access-governed, and shielded from external digital health platforms.
Does Story Health Partners integrate with Epic, Cerner, and other EHRs?
Yes. Story Health’s platform integrates with all major EHR systems — Epic, Oracle Cerner, MEDITECH, Athenahealth, and others — through HL7, FHIR, and direct API connections. Clinical data flows bidirectionally, ensuring providers maintain full visibility into beneficiary care within their existing workflows.
How do I learn more about ACCESS participation with Story Health Partners ?
Visit innovaccer.com/cms-access or contact your Innovaccer representative. Organizations targeting Q1 2027 participation should begin application preparation now.