{"version":"1.0","provider_name":"Medical Office Force","provider_url":"https:\/\/www.medicalofficeforce.com\/es","author_name":"Subodh K. Agrawal, MD, FACC","author_url":"https:\/\/www.medicalofficeforce.com\/es\/author\/subodh-k-agrawal-md-facc\/","title":"What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model? - Medical Office Force","type":"rich","width":600,"height":338,"html":"<blockquote class=\"wp-embedded-content\" data-secret=\"hVVFat4Vd3\"><a href=\"https:\/\/www.medicalofficeforce.com\/es\/what-is-cms-access-model-explained\/\">What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model?<\/a><\/blockquote><iframe sandbox=\"allow-scripts\" security=\"restricted\" src=\"https:\/\/www.medicalofficeforce.com\/es\/what-is-cms-access-model-explained\/embed\/#?secret=hVVFat4Vd3\" width=\"600\" height=\"338\" title=\"&#8220;What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model?&#8221; &#8212; Medical Office Force\" data-secret=\"hVVFat4Vd3\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" scrolling=\"no\" class=\"wp-embedded-content\"><\/iframe><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n\/*! This file is auto-generated *\/\n!function(d,l){\"use strict\";l.querySelector&&d.addEventListener&&\"undefined\"!=typeof URL&&(d.wp=d.wp||{},d.wp.receiveEmbedMessage||(d.wp.receiveEmbedMessage=function(e){var t=e.data;if((t||t.secret||t.message||t.value)&&!\/[^a-zA-Z0-9]\/.test(t.secret)){for(var s,r,n,a=l.querySelectorAll('iframe[data-secret=\"'+t.secret+'\"]'),o=l.querySelectorAll('blockquote[data-secret=\"'+t.secret+'\"]'),c=new RegExp(\"^https?:$\",\"i\"),i=0;i<o.length;i++)o[i].style.display=\"none\";for(i=0;i<a.length;i++)s=a[i],e.source===s.contentWindow&&(s.removeAttribute(\"style\"),\"height\"===t.message?(1e3<(r=parseInt(t.value,10))?r=1e3:~~r<200&&(r=200),s.height=r):\"link\"===t.message&&(r=new URL(s.getAttribute(\"src\")),n=new URL(t.value),c.test(n.protocol))&&n.host===r.host&&l.activeElement===s&&(d.top.location.href=t.value))}},d.addEventListener(\"message\",d.wp.receiveEmbedMessage,!1),l.addEventListener(\"DOMContentLoaded\",function(){for(var e,t,s=l.querySelectorAll(\"iframe.wp-embedded-content\"),r=0;r<s.length;r++)(t=(e=s[r]).getAttribute(\"data-secret\"))||(t=Math.random().toString(36).substring(2,12),e.src+=\"#?secret=\"+t,e.setAttribute(\"data-secret\",t)),e.contentWindow.postMessage({message:\"ready\",secret:t},\"*\")},!1)))}(window,document);\n\/\/# sourceURL=https:\/\/www.medicalofficeforce.com\/wp-includes\/js\/wp-embed.min.js\n\/* ]]> *\/\n<\/script>","thumbnail_url":"https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/2.jpg","thumbnail_width":1920,"thumbnail_height":1100,"description":"What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model? Summary The\u00a0ACCESS Model\u00a0is a 10-year voluntary Medicare initiative designed to scale chronic care management through technology and\u00a0Outcome-Aligned Payments (OAP).\u00a0According to the\u00a0official CMS ACCESS Model overview, it focuses on four clinical tracks and ties 50% of reimbursement to measurable clinical improvements. The CMS Innovation Center (CMMI) introduced the\u00a0Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model\u00a0to transform how Medicare beneficiaries with chronic conditions receive care.\u00a0This model moves away from Fee-For-Service (FFS) toward a &#8220;scalable,&#8221; digital-first approach. The 4 Clinical Tracks of the ACCESS Model The model is structured around four distinct tracks.\u00a0Practices can participate in one or more, depending on their specialty: Early Cardio-Kidney-Metabolic (eCKM):\u00a0Focuses on hypertension, obesity, and pre-diabetes management. Cardio-Kidney-Metabolic (CKM):\u00a0Designed for patients with established heart disease, CKD (Stage 3), and Type 2 diabetes. Musculoskeletal (MSK):\u00a0Targets chronic pain and joint health management. Behavioral Health (BH):\u00a0Focuses on depression, anxiety, and integrated mental health care. The Payment Logic: How Do OAPs Work? The ACCESS model utilizes\u00a0Outcome-Aligned Payments (OAPs)\u00a0instead of traditional care management codes (like CCM or RPM).\u00a0As detailed in the\u00a0CMS Financial Structure and Clinical Performance guide, the payments are two-tiered: Year 1 (Initial Year):\u00a0A higher payment range ($180 \u2013 $420\u00a0per patient) to cover technology onboarding. Follow-on Years:\u00a0A lower maintenance payment range ($90 \u2013 $210\u00a0per patient). The 50% Clinical Outcome Adjustment:\u00a0CMS withholds half of the payment, only releasing it if specific benchmarks (like blood pressure or A1C control) are met. Key Deadlines for 2026 April 1, 2026:\u00a0Application deadline for the first cohort. July 5, 2026:\u00a0Official launch of the first performance year. 2033:\u00a0Expected conclusion of the 10-year test period. Frequently Asked Questions (FAQ) How does ACCESS coordinate with my Primary Care Provider? The model is designed to complement traditional care. Referring clinicians can receive electronic updates on patient progress and may bill a\u00a0new co-management payment\u00a0for reviewing these updates and coordinating care. What are the technical requirements for participants? Organizations must use secure, interoperable systems, including\u00a0CMS APIs\u00a0for enrollment and reporting. They must also designate a\u00a0physician Clinical Director\u00a0to oversee quality and compliance. Learn more about\u00a0IT Infrastructure Support here. What is the &#8220;FFS Exclusion Policy&#8221;? CMS prevents &#8220;double-dipping.&#8221; If a patient is aligned with an ACCESS participant for a specific condition, other providers cannot bill overlapping services like Chronic Care Management (CCM) or Remote Patient Monitoring (RPM) for that same condition. Strategic Verdict The ACCESS model offers massive scale but creates a significant\u00a0revenue gap\u00a0for traditional clinics. Before transitioning, you must analyze your billing data. For a deeper look at the $2,000 revenue gap this model creates,\u00a0read our full analysis on High-Touch vs. High-Tech Scale here. Schedule a Revenue Protection Audit today\u00a0to see how your practice can survive these Medicare changes."}