ACCESS Model: Preparing Your Practice for New Payment and Quality Models

Primary care has been steadily moving away from “get paid per visit” toward models that reward outcomes, coordination, and chronic care. CMS has reinforced this shift through changes to the Physician Fee Schedule, evolution of MIPS and ACO programs, and a clear goal to have most Medicare patients in some form of value-based arrangement by 2030.

A key part of that future is the new ACCESS Model—Advancing Chronic Care with Effective, Scalable Solutions. This blog offers a straightforward overview of what ACCESS is and a practical checklist to help your practice get ready for new payment and quality expectations.

What is the ACCESS Model?

The ACCESS Model is a new CMS Innovation Center model focused on improving chronic disease management using technology-enabled care. From recent federal and policy briefings, several features stand out:

• Voluntary model in Original Medicare
  ACCESS is not mandatory, but it’s designed to be attractive to organizations already investing in chronic care.

• Outcome-aligned payments
  Instead of paying only for the number of visits or services, ACCESS ties payments to the share of patients who meet specific health targets—for example, control of chronic conditions or engagement in ongoing care.

• Technology-enabled chronic care
  ACCESS is explicitly framed as a technology-supported model, encouraging the use of remote monitoring, virtual care, and other digital tools alongside traditional primary care.

• Long time horizon
  The model is set to launch on July 5, 2026 and run for up to 10 years, giving practices and partners time to adapt and refine their approach.

• New co-management payment
  Referring clinicians can bill a Co-Management Payment when they review chronic care progress updates from ACCESS partners and incorporate that information into their ongoing care for the patient.

ACCESS is meant to work alongside pathways many practices already know—such as MIPS, MSSP ACOs, and ACO REACH—as part of a broader push to reward high-value primary care rather than sheer volume of encounters.

Why ACCESS matters for primary care

Even if your organization never becomes an ACCESS participant, the model is a useful preview of where payment and quality programs are heading.

1. Stronger link between chronic outcomes and revenue

ACCESS makes explicit what many value-based contracts are already trying to do: pay more when patients are healthier. That means:

• Better chronic disease control and preventive care

• Fewer avoidable hospitalizations and ED visits

• Structured follow-up and care coordination

For primary care, that translates into a need for clear registries, reliable data, and repeatable chronic care workflows, not just reactive visit-based care.

2. Clear expectation of technology-enabled care

By design, ACCESS leans on technology-supported chronic care—for example, connected devices, remote monitoring, or digital behavior change programs—paired with longitudinal relationships in primary care.

That expectation is likely to spill over into other CMS and commercial contracts: practices will be asked to share data, coordinate with virtual partners, and document co-management work in a reliable, auditable way.

3. Higher bar for measurement and documentation

Most value-based programs already depend on structured data and quality reporting (via eCQMs, registries, or claims-based measures). ACCESS continues that trend by linking payment to measurable outcomes and process metrics rather than time spent alone.

Practices that:

• Capture chronic care work in structured fields,

• Have a handle on panel-level metrics, and

• Understand how their data flows to payers and networks

will be in a much better position than those relying on free-text notes and ad hoc reporting.

How to prepare: A simple checklist for practices

You don’t need to become a policy expert to prepare for ACCESS and similar models. Focus on the basics that will help you succeed across any new payment and quality program.

1. Map your current and near-term payment landscape

Start by answering a few questions with your leadership, clinical, and billing teams:

• What share of our revenue today is pure fee-for-service, and what share is tied to MIPS, ACOs, or other value-based arrangements?

• Are we already in—or actively considering—MSSP ACOs, ACO REACH, LEAD/AHEAD, or enhanced care management codes (like chronic care management or new APCM bundles)?

• Which payers are most likely to bring new chronic care or outcome-based programs to our region in the next 1–3 years?

This gives you a clearer view of where ACCESS or similar models might fit and what level of risk and operational change your team is ready to absorb.

2. Understand your chronic care population

ACCESS is all about chronic conditions, so it’s important to know:

• How many patients have two or more chronic conditions, and which conditions are most prevalent?

• Where you see the biggest care gaps: missed follow-ups, poor control of key metrics, or social risk factors that complicate care.

• Which clinicians and staff are currently doing most of the work to keep these patients stable—and how much of that work is clearly documented.

If you have population health or reporting tools, create simple, recurring reports that highlight your highest-need chronic care cohorts and track trends over time.

3. Tighten quality and documentation foundations

Next, focus on making sure that the work you already do shows up in your data:

• Pick a core set of measures that overlap with your current and likely future programs (MIPS, ACO, commercial VBPs).

• Standardize documentation for chronic care visits and non-visit touchpoints (phone calls, portal messages, care management) so it’s easier to report and bill appropriately.

• Confirm how your organization reports quality data today—through eCQMs, registry submission, or claims—and whether those pipelines are reliable.

If your current approach to documentation and reporting already feels brittle for MIPS or ACO reporting, ACCESS will likely amplify that pressure rather than relieve it.

4. Clarify how you’ll work with external partners

Because ACCESS assumes collaboration with external, tech-enabled chronic care programs, practices should think ahead about co-management:

• How will referrals into technology-supported programs be initiated and tracked?

• Who on your team will review updates from those partners, and how often?

• How will you document that review and any changes to the care plan, both for clinical safety and for billing co-management payments when allowed?

You don’t need every detail worked out today, but a simple co-management playbook—even at the level of “who does what, and where it lives in the chart”—will make new programs much less disruptive.

5. Build literacy and confidence around value-based care

Finally, invest in making sure your team understands the “why” behind these programs, not just the rules:

• Offer short, focused education on how value-based payment programs work, what they reward, and how they connect to the daily work clinicians already do.

• Share simple visuals or one-page summaries from trusted sources that explain the major pathways: Traditional MIPS vs. MVPs, ACO models, and newer chronic care models like ACCESS.

• Encourage open discussion of concerns—especially about workload, documentation expectations, and financial risk—so changes feel transparent, not imposed.

When clinicians and staff can see how these models support better chronic care and more predictable revenue, it’s easier to bring them along on the journey.

The takeaway: Start with what you can control

The details of ACCESS will continue to evolve as CMS finalizes guidance and early participants begin to share experiences. But the core direction is clear:

• Chronic care, outcomes, and coordination will drive more of your revenue.

• Technology and data sharing will be expected, not optional.

• Clear documentation and quality reporting will be non-negotiable.

By focusing now on your chronic care population, data quality, workflows, and team education, you’ll be better prepared not only for ACCESS, but for whatever new payment and quality models come next.

You don’t have to do everything at once—but taking a few concrete steps this year can make 2026 feel like an opportunity to grow, not just another regulatory hurdle.

If you’re looking for a technology partner to help you operationalize value-based care—without losing sight of the patient relationship—Elation supports primary care practices with tools and workflows designed for chronic care, quality reporting, and sustainable financial performance.

Learn more about Elation.