CMS Launches ACCESS 10-Year Program To Reimburse Measurable Outcomes For Chronic Disease Care

The Centers for Medicare & Medicaid Services launched ACCESS, a 10-year program that goes live July 5 and shifts reimbursement from billable hours to measurable health outcomes for chronic disease management.

“CMS launched ACCESS, a 10-year program going live July 5”

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ACCESS is designed to create a payment mechanism for AI agents that monitor patients between visits, coordinate housing referrals, and ensure medication adherence, tasks traditional Medicare does not reimburse.

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Neil Batlivala, CEO of Pair Team, said, “The government is creating swim lanes for AI innovation in traditionally regulated industries.”

Batlivala also described the program’s novelty as a “payment model transformation,” adding, “You just couldn’t do this before.”

Pair Team was accepted as one of 150 organizations in the first cohort, and it uses a voice AI agent named Flora as its primary patient-facing interface.

Flora handles intake, coordinates referrals, and performs check-ins 24 hours a day, and Batlivala said a first call with a 67-year-old woman living out of her car, managing PTSD and congestive heart failure, lasted over an hour.

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Batlivala told TechCrunch, “Flora was probably the only 'person' she'd talked to in weeks about her situation.”

The ACCESS payment structure covers conditions including diabetes, hypertension, chronic kidney disease, obesity, depression, and anxiety, and organizations earn the full amount only when patients meet measurable health goals like lower blood pressure or reduced pain.

ACCESS feeds extraordinarily sensitive patient data—intimate conversations about housing, disease, and mental illness—into a federal infrastructure with a documented history of breaches, including exposed Social Security numbers.

“amplifies security risk over sensitive patient data”

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CryptoRank warned that the program “amplifies security risk over sensitive patient data,” even as it accelerates AI adoption and commercialization of scalable care.

The program’s financial backdrop includes a 2023 Congressional Budget Office finding of $5.4 billion in added spending from prior CMS innovations, and CryptoRank said it faces budget and reimbursement pressure.

In parallel, the Tech Buzz framing emphasized that ACCESS creates the first federal reimbursement mechanism for AI systems that monitor patients between visits and coordinate housing referrals, positioning the policy shift as a new revenue path for healthcare AI.