{"id":35258,"date":"2026-04-08T11:36:10","date_gmt":"2026-04-08T15:36:10","guid":{"rendered":"https:\/\/www.medicalofficeforce.com\/?p=35258"},"modified":"2026-04-13T09:33:53","modified_gmt":"2026-04-13T13:33:53","slug":"what-is-cms-access-model-explained","status":"publish","type":"post","link":"https:\/\/www.medicalofficeforce.com\/es\/what-is-cms-access-model-explained\/","title":{"rendered":"What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model?"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"35258\" class=\"elementor elementor-35258\">\n\t\t\t\t<div class=\"elementor-element elementor-element-59879ed e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-equal-height-no e-con e-parent\" data-id=\"59879ed\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6245886 elementor-widget elementor-widget-image\" data-id=\"6245886\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1920\" height=\"1100\" src=\"https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/2.jpg\" class=\"attachment-full size-full wp-image-35259\" alt=\"\" srcset=\"https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/2.jpg 1920w, https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/2-300x172.jpg 300w, https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/2-1024x587.jpg 1024w, https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/2-768x440.jpg 768w, https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/2-1536x880.jpg 1536w, https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/2-685x392.jpg 685w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2d18701 e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-equal-height-no e-con e-parent\" data-id=\"2d18701\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-300a58a elementor-widget elementor-widget-shortcode\" data-id=\"300a58a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4b5b086 elementor-widget elementor-widget-heading\" data-id=\"4b5b086\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model?\n<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c42a37b elementor-widget elementor-widget-shortcode\" data-id=\"c42a37b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n                \n                    <!--begin code -->\n\n                    \n                    <div class=\"pp-multiple-authors-boxes-wrapper pp-multiple-authors-wrapper pp-multiple-authors-layout-boxed multiple-authors-target-shortcode box-post-id-4775 box-instance-id-1 ppma_boxes_4775\"\n                    data-post_id=\"4775\"\n                    data-instance_id=\"1\"\n                    data-additional_class=\"pp-multiple-authors-layout-boxed.multiple-authors-target-shortcode\"\n                    data-original_class=\"pp-multiple-authors-boxes-wrapper pp-multiple-authors-wrapper box-post-id-4775 box-instance-id-1\">\n                                                <span class=\"ppma-layout-prefix\"><\/span>\n                        <div class=\"ppma-author-category-wrap\">\n                                                                                                                                    <span class=\"ppma-category-group ppma-category-group-1 category-index-0\">\n                                                                                                                        <ul class=\"pp-multiple-authors-boxes-ul author-ul-0\">\n                                                                                                                                                                                                                                                                                                                                                            \n                                                                                                                    <li class=\"pp-multiple-authors-boxes-li author_index_0 author_subodh-k-agrawal-md-facc has-avatar\">\n                                                                                                                                                                                    <div class=\"pp-author-boxes-avatar\">\n                                                                    <div class=\"avatar-image\">\n                                                                                                                                                                                                                <img alt='Subodh K. Agrawal, MD, FACC' src='https:\/\/secure.gravatar.com\/avatar\/5c1fa22b7bc8906e4efbe318cb64ccba8fc64360bdc50409aab874e8743c99ef?s=60&#038;d=https%3A%2F%2Fwww.ahcspc.com%2Fwp-content%2Fuploads%2F2025%2F11%2Favtar10.png&#038;r=g' srcset='https:\/\/secure.gravatar.com\/avatar\/5c1fa22b7bc8906e4efbe318cb64ccba8fc64360bdc50409aab874e8743c99ef?s=120&#038;d=https%3A%2F%2Fwww.ahcspc.com%2Fwp-content%2Fuploads%2F2025%2F11%2Favtar10.png&#038;r=g 2x' class='avatar avatar-60 photo' height='60' width='60' \/>                                                                                                                                                                                                            <\/div>\n                                                                                                                                    <\/div>\n                                                            \n                                                            <div class=\"pp-author-boxes-avatar-details\">\n                                                                <div class=\"pp-author-boxes-name multiple-authors-name\"><a href=\"https:\/\/www.medicalofficeforce.com\/es\/author\/subodh-k-agrawal-md-facc\/\" rel=\"author\" title=\"Subodh K. Agrawal, MD, FACC\" class=\"author url fn\">By Subodh K. Agrawal, MD, FACC<\/a><\/div>                                                                                                                                                                                                    \n                                                                                                                                            <div class=\"pp-author-boxes-description multiple-authors-description author-description-0\">\n                                                                                                                                                    <p>Medical Director, Medical Office Force LLC | Athens, Georgia<br \/>\nAlumnus: SMS Medical College, Emory University, University of Alabama at Birmingham<\/p>\n                                                                                                                                                <\/div>\n                                                                                                                                                                                                    \n                                                                                                                                \n                                                                                                                            <\/div>\n                                                                                                                                                                                                                        <\/li>\n                                                                                                                                                                                                                                                                                        <\/ul>\n                                                                            <\/span>\n                                                                                                                        <\/div>\n                        <span class=\"ppma-layout-suffix\"><\/span>\n                                            <\/div>\n                    <!--end code -->\n                    \n                \n                            \n        <\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b8896c8 elementor-widget elementor-widget-shortcode\" data-id=\"b8896c8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f11594e elementor-widget elementor-widget-heading\" data-id=\"f11594e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Summary\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7c9e112 elementor-widget elementor-widget-text-editor\" data-id=\"7c9e112\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The\u00a0<b>ACCESS Model<\/b>\u00a0is a 10-year voluntary Medicare initiative designed to scale chronic care management through technology and\u00a0<a href=\"https:\/\/www.medicalofficeforce.com\/cms-access-model-payment-oap-explained\/\"><strong>Outcome-Aligned Payments (OAP)<\/strong><\/a>.\u00a0According to the\u00a0<a href=\"https:\/\/www.cms.gov\/priorities\/innovation\/innovation-models\/access\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/www.cms.gov\/priorities\/innovation\/innovation-models\/access&amp;source=gmail&amp;ust=1775805368238000&amp;usg=AOvVaw13tC_SkSm04J8Z-TTNfa2i\">official CMS ACCESS Model overview<\/a>, it focuses on four clinical tracks and ties 50% of reimbursement to measurable clinical improvements.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-45437e1 elementor-widget elementor-widget-text-editor\" data-id=\"45437e1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p id=\"m_-8455616624011578967gmail-p-rc_2653ff78338d7be7-60\">The CMS Innovation Center (CMMI) introduced the\u00a0<b>Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model<\/b>\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.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-77bcf12 elementor-widget elementor-widget-image\" data-id=\"77bcf12\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"685\" height=\"374\" src=\"https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/what-is-the-cms-access-model-tracks-oap-explained-compressed-1024x559.jpg\" class=\"attachment-large size-large wp-image-35263\" alt=\"\" srcset=\"https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/what-is-the-cms-access-model-tracks-oap-explained-compressed-1024x559.jpg 1024w, https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/what-is-the-cms-access-model-tracks-oap-explained-compressed-300x164.jpg 300w, https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/what-is-the-cms-access-model-tracks-oap-explained-compressed-768x419.jpg 768w, https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/what-is-the-cms-access-model-tracks-oap-explained-compressed-685x374.jpg 685w, https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/what-is-the-cms-access-model-tracks-oap-explained-compressed.jpg 1200w\" sizes=\"(max-width: 685px) 100vw, 685px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-72fde1d elementor-widget elementor-widget-heading\" data-id=\"72fde1d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">The 4 Clinical Tracks of the ACCESS Model\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-73a4aad elementor-widget elementor-widget-text-editor\" data-id=\"73a4aad\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p id=\"m_-8455616624011578967gmail-p-rc_2653ff78338d7be7-61\">The model is structured around four distinct tracks.\u00a0Practices can participate in one or more, depending on their specialty:<\/p><ul><li><p id=\"m_-8455616624011578967gmail-p-rc_2653ff78338d7be7-62\"><b>Early Cardio-Kidney-Metabolic (eCKM):<\/b>\u00a0Focuses on hypertension, obesity, and pre-diabetes management.<\/p><\/li><li><p id=\"m_-8455616624011578967gmail-p-rc_2653ff78338d7be7-63\"><b>Cardio-Kidney-Metabolic (CKM):<\/b>\u00a0Designed for patients with established heart disease, CKD (Stage 3), and Type 2 diabetes.<\/p><\/li><li><p id=\"m_-8455616624011578967gmail-p-rc_2653ff78338d7be7-64\"><b>Musculoskeletal (MSK):<\/b>\u00a0Targets chronic pain and joint health management.<\/p><\/li><li><p id=\"m_-8455616624011578967gmail-p-rc_2653ff78338d7be7-65\"><b>Behavioral Health (BH):<\/b>\u00a0Focuses on depression, anxiety, and integrated mental health care.<\/p><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-df8373b elementor-widget elementor-widget-heading\" data-id=\"df8373b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">The Payment Logic: How Do OAPs Work?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-767899e elementor-widget elementor-widget-text-editor\" data-id=\"767899e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p id=\"m_-8455616624011578967gmail-p-rc_2653ff78338d7be7-66\">The ACCESS model utilizes\u00a0<b>Outcome-Aligned Payments (OAPs)<\/b>\u00a0instead of traditional care management codes (like CCM or RPM).\u00a0As detailed in the\u00a0<a href=\"https:\/\/www.cms.gov\/priorities\/innovation\/files\/access-payments-amts-perf-targets.pdf\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/www.cms.gov\/priorities\/innovation\/files\/access-payments-amts-perf-targets.pdf&amp;source=gmail&amp;ust=1775805368238000&amp;usg=AOvVaw3k2U6qGq3nI8AlPLSiL_kr\">CMS Financial Structure and Clinical Performance guide<\/a>, the payments are two-tiered:<\/p><ul><li><p><b>Year 1 (Initial Year):<\/b>\u00a0A higher payment range (<b>$180 \u2013 $420<\/b>\u00a0per patient) to cover technology onboarding.<\/p><\/li><li><p id=\"m_-8455616624011578967gmail-p-rc_2653ff78338d7be7-67\"><b>Follow-on Years:<\/b>\u00a0A lower maintenance payment range (<b>$90 \u2013 $210<\/b>\u00a0per patient).<\/p><\/li><li><p id=\"m_-8455616624011578967gmail-p-rc_2653ff78338d7be7-68\"><b>The 50% Clinical Outcome Adjustment:<\/b>\u00a0CMS withholds half of the payment, only releasing it if specific benchmarks (like blood pressure or A1C control) are met.<\/p><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ac1a540 elementor-widget elementor-widget-heading\" data-id=\"ac1a540\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Key Deadlines for 2026\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7ec7f28 elementor-widget elementor-widget-text-editor\" data-id=\"7ec7f28\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li><p id=\"m_-8455616624011578967gmail-p-rc_2653ff78338d7be7-69\"><b>April 1, 2026:<\/b>\u00a0Application deadline for the first cohort.<\/p><\/li><li><p id=\"m_-8455616624011578967gmail-p-rc_2653ff78338d7be7-70\"><b>July 5, 2026:<\/b>\u00a0Official launch of the first performance year.<\/p><\/li><li><p><b>2033:<\/b>\u00a0Expected conclusion of the 10-year test period.<\/p><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-12251b7 elementor-widget elementor-widget-heading\" data-id=\"12251b7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Frequently Asked Questions (FAQ)\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e69a24c elementor-widget elementor-widget-text-editor\" data-id=\"e69a24c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3 style=\" font-size:17px;text-transform:capitalize;font-weight:400 !important;\">How does ACCESS coordinate with my Primary Care Provider?<\/h3>\nThe model is designed to complement traditional care. Referring clinicians can receive electronic updates on patient progress and may bill a\u00a0<b>new co-management payment<\/b>\u00a0for reviewing these updates and coordinating care.\n<h3 style=\" font-size:17px;text-transform:capitalize;font-weight:400 !important;\">What are the technical requirements for participants?<\/h3>\nOrganizations must use secure, interoperable systems, including\u00a0<b>CMS APIs<\/b>\u00a0for enrollment and reporting. They must also designate a\u00a0<b>physician Clinical Director<\/b>\u00a0to oversee quality and compliance. Learn more about\u00a0<a href=\"https:\/\/www.medicalofficeforce.com\/healthcare-it\/\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/www.medicalofficeforce.com\/healthcare-it\/&amp;source=gmail&amp;ust=1775805368238000&amp;usg=AOvVaw3H644cmTZW31Mx6xfHmMVl\">IT Infrastructure Support here<\/a>.\n<h3 style=\" font-size:17px;text-transform:capitalize;font-weight:400 !important;\">What is the &#8220;FFS Exclusion Policy&#8221;?<\/h3>\nCMS 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.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a5c6d8c elementor-widget elementor-widget-heading\" data-id=\"a5c6d8c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Strategic Verdict\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4432ea6 elementor-widget elementor-widget-text-editor\" data-id=\"4432ea6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The ACCESS model offers massive scale but creates a significant\u00a0<b>revenue gap<\/b>\u00a0for traditional clinics. Before transitioning, you must analyze your billing data.<\/p><p><b>For a deeper look at the $2,000 revenue gap this model creates,\u00a0<a href=\"https:\/\/www.medicalofficeforce.com\/high-touch-healing-vs-high-tech-scale-navigating-medicares-new-access-model\/\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/www.medicalofficeforce.com\/high-touch-healing-vs-high-tech-scale-navigating-medicares-new-access-model\/&amp;source=gmail&amp;ust=1775805368238000&amp;usg=AOvVaw0qYvCNCMBXvtCo7K4xboxh\">read our full analysis on High-Touch vs. High-Tech Scale here<\/a>.<\/b><\/p><p><b><a href=\"https:\/\/www.medicalofficeforce.com\/contact-us\/\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/www.medicalofficeforce.com\/contact-us\/&amp;source=gmail&amp;ust=1775805368238000&amp;usg=AOvVaw0HVl_vEJC1OuOsPC8DXZhf\">Schedule a Revenue Protection Audit today<\/a><\/b>\u00a0to see how your practice can survive these Medicare changes.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-16523ec elementor-widget elementor-widget-html\" data-id=\"16523ec\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<script type=\"application\/ld+json\">\r\n{\r\n  \"@context\": \"https:\/\/schema.org\",\r\n  \"@type\": \"MedicalWebPage\",\r\n  \"headline\": \"What is CMS ACCESS Model? Payments, Tracks & Impact\",\r\n  \"description\": \"Learn the essentials of the CMS ACCESS Model, including the 4 clinical tracks, Outcome-Aligned Payments (OAP), and the 50% withholding logic with official insights from Medical Office Force.\",\r\n  \"url\": \"https:\/\/www.medicalofficeforce.com\/what-is-cms-access-model-explained\/\",\r\n  \"datePublished\": \"2026-04-08T08:00:00+08:00\",\r\n  \"dateModified\": \"2026-04-08T08:00:00+08:00\",\r\n  \"author\": {\r\n    \"@type\": \"Person\",\r\n    \"name\": \"Subodh K. Agrawal, MD, FACC\",\r\n    \"url\": \"https:\/\/www.medicalofficeforce.com\/about-us\/\",\r\n    \"jobTitle\": \"Medical Director\",\r\n    \"worksFor\": {\r\n      \"@type\": \"MedicalOrganization\",\r\n      \"name\": \"Medical Office Force LLC\",\r\n      \"logo\": \"https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2025\/02\/Group-451.png\",\r\n      \"address\": {\r\n        \"@type\": \"PostalAddress\",\r\n        \"addressLocality\": \"Athens\",\r\n        \"addressRegion\": \"GA\"\r\n      }\r\n    }\r\n  },\r\n  \"publisher\": {\r\n    \"@type\": \"Organization\",\r\n    \"name\": \"Medical Office Force LLC\",\r\n    \"logo\": {\r\n      \"@type\": \"ImageObject\",\r\n      \"url\": \"https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2025\/02\/Group-451.png\"\r\n    }\r\n  },\r\n  \"primaryImageOfPage\": {\r\n    \"@type\": \"ImageObject\",\r\n    \"url\": \"https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/what-is-the-cms-access-model-clinical-tracks-guide-medicalofficeforce.webp\",\r\n    \"caption\": \"A guide to CMMI's ACCESS Model detailing the 4 tracks and Outcome-Aligned Payments (OAPs) by Dr. Subodh Agrawal, M.D., FACC, and Medical Office Force LLC.\"\r\n  },\r\n  \"mainEntity\": [\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"How does ACCESS coordinate with my Primary Care Provider?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"The ACCESS model is designed to complement traditional care. 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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.\"\r\n      }\r\n    }\r\n  ]\r\n}\r\n<\/script>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>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.<\/p>","protected":false},"author":221724652,"featured_media":35259,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1407,1],"tags":[],"ppma_author":[1447],"class_list":["post-35258","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ccm","category-rcm"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model? - Medical Office Force<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.medicalofficeforce.com\/es\/what-is-cms-access-model-explained\/\" \/>\n<meta property=\"og:locale\" content=\"es_MX\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model? - Medical Office Force\" \/>\n<meta property=\"og:description\" content=\"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.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.medicalofficeforce.com\/es\/what-is-cms-access-model-explained\/\" \/>\n<meta property=\"og:site_name\" content=\"Medical Office Force\" \/>\n<meta property=\"article:published_time\" content=\"2026-04-08T15:36:10+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-13T13:33:53+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/2.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1920\" \/>\n\t<meta property=\"og:image:height\" content=\"1100\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Subodh K. Agrawal, MD, FACC\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Subodh K. Agrawal, MD, FACC\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tiempo de lectura\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/what-is-cms-access-model-explained\\\/\",\"url\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/what-is-cms-access-model-explained\\\/\",\"name\":\"What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model? - Medical Office Force\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/what-is-cms-access-model-explained\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/what-is-cms-access-model-explained\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/wp-content\\\/uploads\\\/2026\\\/04\\\/2.jpg\",\"datePublished\":\"2026-04-08T15:36:10+00:00\",\"dateModified\":\"2026-04-13T13:33:53+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/#\\\/schema\\\/person\\\/8fc70cd716708631b2bc810cc38f7384\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/what-is-cms-access-model-explained\\\/#breadcrumb\"},\"inLanguage\":\"es\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.medicalofficeforce.com\\\/what-is-cms-access-model-explained\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/what-is-cms-access-model-explained\\\/#primaryimage\",\"url\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/wp-content\\\/uploads\\\/2026\\\/04\\\/2.jpg\",\"contentUrl\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/wp-content\\\/uploads\\\/2026\\\/04\\\/2.jpg\",\"width\":1920,\"height\":1100},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/what-is-cms-access-model-explained\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/#website\",\"url\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/\",\"name\":\"Medical Office Force\",\"description\":\"Optimizing Healthcare Finance\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.medicalofficeforce.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"es\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model? - Medical Office Force","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.medicalofficeforce.com\/es\/what-is-cms-access-model-explained\/","og_locale":"es_MX","og_type":"article","og_title":"What is CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model? - Medical Office Force","og_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.","og_url":"https:\/\/www.medicalofficeforce.com\/es\/what-is-cms-access-model-explained\/","og_site_name":"Medical Office Force","article_published_time":"2026-04-08T15:36:10+00:00","article_modified_time":"2026-04-13T13:33:53+00:00","og_image":[{"width":1920,"height":1100,"url":"https:\/\/www.medicalofficeforce.com\/wp-content\/uploads\/2026\/04\/2.jpg","type":"image\/jpeg"}],"author":"Subodh K. Agrawal, MD, FACC","twitter_card":"summary_large_image","twitter_misc":{"Escrito por":"Subodh K. 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