Medicare's ACCESS Program Opens AI-Driven Payment Model for Chronic Care

On April 30, the Centers for Medicare & Medicaid Services (CMS) introduced ACCESS (Advancing Chronic Care with Effective, Scalable Solutions), a decade-long initiative aimed at evaluating a payment model that incentivizes health outcomes. Among the 150 organizations participating is Pair Team, a healthcare firm established in 2019, which employs 850 staff members and plans to serve one million patients within three years. The program will commence on July 5 and will address conditions such as diabetes, hypertension, chronic kidney disease, obesity, depression, and anxiety. Organizations will receive stable payments and can earn full compensation when patients achieve specific health targets, such as reduced blood pressure. This marks the first instance where Medicare can compensate for AI tools that monitor patients. However, risks include potential data breaches and financial viability, with a CBO report predicting a $5.4 billion increase in spending.