The Centers for Medicare and Medicaid Services (CMS) Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model1 is a voluntary CMS Innovation Center initiative designed to improve outcomes for Medicare fee for service (FFS) beneficiaries with chronic conditions through technology-enabled care. CMS announced the initial cohort of over 150 ACCESS participants in April 2026.2 These participants reflect a diverse mix of technology-enabled care organizations, digital health companies, and provider groups that focus on delivering longitudinal, condition-specific management across early-stage and established cardio kidney metabolic, musculoskeletal, and behavioral health populations. The model launched on July 5, 2026, at which point the first cohort could begin enrolling Medicare beneficiaries. Additional organizations can still apply on a rolling basis and join starting January 1, 2027.
ACCESS uses a payment model tied directly to outcomes. Participants receive prospective payments linked to four clinical tracks (early cardio-kidney-metabolic, cardio-kidney-metabolic, musculoskeletal, behavioral health). Final payments are then adjusted in two ways.
- If too few patients hit their health targets, the ACCESS participant earns less (clinical outcome adjustment—at least 50% of enrolled patients must meet targets for the initial effective period).
- If patients receive the same services elsewhere—outside the ACCESS Model—the ACCESS participant earns less (substitute spend adjustment).
CMS ACCESS Model and ACOs at a glance
150+
participants
4
clinical tracks
~50%
of Medicare beneficiaries with
ACO relationship in 2025
Together, these mechanisms incentivize consistent, coordinated care across the population.
Accountable care organizations (ACOs) are already accountable for the total cost of care and quality of care for attributed Medicare populations under models such as the Medicare Shared Savings Program (MSSP)3 and Realizing Equity, Access, and Community Health (REACH)4. Reflecting the widespread scale of accountable care, more than half of Medicare FFS beneficiaries are in an accountable care relationship with a provider in 2025.5 Because ACOs are financially and operationally incentivized to improve outcomes and reduce unnecessary utilization, ACOs represent natural partners for ACCESS participants seeking to scale enrollment, strengthen care coordination, and achieve performance-based payment targets.
Here are four ways that ACCESS participants and ACOs can naturally align to improve patient care and support each other’s financial performance.
- Enhanced efficiencies: When ACOs and ACCESS Model participants partner, it helps providers build scale and credibility through attributed beneficiaries.
ACCESS participants require a reliable referral source to identify and engage eligible beneficiaries. By referring appropriate patients from their attributed populations, ACOs can help participants scale enrollment more effectively while minimizing the need for ACCESS participants to verify patient eligibility on their own.
Establishing these partnerships and care coordination pathways early is critical to longer-term strategy. In the near term, ACCESS participation will expand ACO capacity to enhance care management without affecting benchmark calculations. Beginning in 2028, ACCESS-related costs will be included in total cost of care calculations, making close coordination increasingly important for both patient outcomes and financial success.
- Shared goals: ACCESS Model participants and ACOs both benefit by aligning around mutual financial and clinical goals.
Partnerships between ACCESS participants and ACOs create a clear win-win by aligning technology-enabled interventions such as telehealth platforms, wearable health-monitoring devices, and digital coaching applications, with shared financial and clinical goals. ACOs are accountable for total cost of care and quality outcomes, while ACCESS participants seek to expand their market reach by delivering scalable solutions. These solutions:
- Enhance patient engagement
- Close care gaps
- Support preventive care
- Improve medication adherence
- Facilitate remote monitoring
- Address social determinants of health
- Provide proactive longitudinal care management
These capabilities directly contribute to improved performance on key quality and population health measures (e.g., blood pressure control, diabetes management (HbA1c), medication adherence, depression management, and overall utilization reduction). This enhances ACOs’ ability to achieve savings and quality targets, while positioning ACCESS Model participants as accountable population health partners rather than point-solution vendors.
- Data integration: By partnering, ACCESS Model participants and ACOs can integrate data to strengthen care coordination, reduce fragmentation, and optimize reimbursement.
One of the most persistent challenges in value-based care is that patients are largely unmonitored between clinical encounters. This limits visibility into missed medication fills, worsening symptoms, or gaps in follow-up care before they become costly. This lack of visibility is a direct financial risk for ACCESS participants, since fragmented care and duplicative services can trigger substitute spend adjustments that reduce participants’ payments. Structured data sharing between ACCESS participants and ACOs, including inputs from remote monitoring, digital therapeutics, and technology-enabled engagement data integrated into ACO workflows, can provide near-real-time visibility into patient status and adherence. This enables earlier intervention and reduces the likelihood of duplicative services. In turn, shared access to this data supports a more complete view of the patient, driving improved consistency of care across providers and increased likelihood of meeting outcome-based payment thresholds.
- Stronger credibility: By partnering, ACOs and ACCESS Model participants can demonstrate performance through public reporting
Both ACCESS participants and ACOs are subject to public reporting of performance. This creates a shared reputational stake in outcomes. Strong real-world results within a CMS model demonstrate credibility for ACCESS participants looking to expand into Medicare Advantage, Medicaid, and commercial populations. Meanwhile, performance transparency provides ACOs with visibility into how ACCESS participants’ solutions are performing within their attributed populations, helping inform decisions about which partnerships are strengthening their performance and should be expanded. Demonstrated success in ACCESS Model partnerships can also support ACO growth by helping attract and retain providers seeking high-performing, outcomes-focused care models. This mutual transparency supports a more collaborative, outcomes-based partnership model in which both organizations are accountable not only to one another, but also to the public.
For organizations evaluating whether to participate in future ACCESS cohorts, the model represents an opportunity to demonstrate the effectiveness of technology-enabled care within a CMS Innovation Center initiative while building relationships with value-based care organizations. As discussed in Milliman's article, "CMMI's ACCESS model: What health tech providers, life sciences organizations, and ACOs need to know" CMS' ACCESS model creates a pathway for organizations to generate real-world evidence of clinical and financial impact; establish credibility with providers and payers; and position successful interventions for expansion into Medicare Advantage, Medicaid, and commercial populations. Organizations considering participation should begin evaluating potential provider and ACO partnerships early, as beneficiary identification, referral pathways, and data-sharing capabilities will be important drivers of success.
Looking ahead: Partnerships between accountable care organizations and ACCESS Model participants offer mutual benefits
Strong ACO and ACCESS-aligned partnerships position participants to translate value-based capabilities into broad, sustainable growth across payer segments. ACCESS participants can succeed by proactively identifying, evaluating, and partnering with ACOs to accelerate beneficiary enrollment, improve outcomes, and demonstrate value-based performance. ACOs should evaluate ACCESS participants as strategic partners that can enhance chronic disease management, improve quality performance, and support total cost of care objectives. These relationships enable scalable approaches to managing cost, utilization, and outcomes that extend beyond a single model and support long-term performance.
Milliman can support ACCESS participants through advanced analytics, provider profiling, and performance monitoring. This includes identifying high-value provider partners, analyzing beneficiary populations, and tracking clinical outcome and substitute spend performance. Additionally, Milliman can help ACOs assess the financial impact of partnering with ACCESS participants, measure the effectiveness of specific interventions, and identify opportunities for scaling solutions that demonstrate meaningful clinical and economic value.
1 ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model. (n.d.). CMS.gov. Retrieved July 1, 2026, from https://www.cms.gov/priorities/innovation/innovation-models/access.
2 ACCESS Model Accepted Applicants. (May 27, 2026). CMS.gov. Retrieved July 1, 2026, from https://www.cms.gov/priorities/innovation/access-model-accepted-applicants.
3 Shared Savings Program. (n.d.). CMS.gov. Retrieved July 1, 2026, from https://www.cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos.
4 ACO REACH Model. (n.d.). CMS.gov. Retrieved July 1, 2026, from https://www.cms.gov/priorities/innovation/innovation-models/aco-reach.
5 CMS Moves Closer to Accountable Care Goals With 2025 ACO Initiatives. (January 15, 2025). CMS.gov. Retrieved July 1, 2026, from https://www.cms.gov/newsroom/fact-sheets/cms-moves-closer-accountable-care-goals-2025-aco-initiatives.