The Centers for Medicare and Medicaid Services is expanding an experiment to pay for technologies used to care for chronic conditions.
The Advancing Chronic Care with Effective, Scalable Solutions, or ACCESS model, which launched just two months ago, is expanding to cover more health conditions. Starting next spring, the program will include tracks for heart failure, chronic obstructive pulmonary disease, substance use disorders and tobacco cessation. The expansion also includes more support for musculoskeletal conditions beyond the initial 12-month care period, the CMS said in a Tuesday announcement.
The current and expanded tracks will cover conditions affecting roughly three in four people with Medicare, Jacob Shiff, CMS’ chief AI and technology officer, said in a Tuesday presentation. Currently, the program covers cardio-metabolic, musculoskeletal and behavioral health conditions. It’s expected to run for 10 years.
The ACCESS model lets participating health organizations earn monthly payments for using digital technologies to manage chronic conditions, based on health outcomes. More than 160 companies have signed up for the program, according to the CMS, most of which have not previously worked with people covered by Medicare.
The participants include several smaller telehealth providers, meditation app Headspace, an artificial intelligence chatbot tool called Welldoc and a physician services group started by wearable firm Whoop.
A related Food and Drug Administration program allows digital health devices that have not been authorized by the agency to collect real-world data through the ACCESS program. So far, four participants have been selected for the FDA counterpart, called Technology-Enabled Meaningful Patient Outcomes, or TEMPO. Those companies, some of which are also on ACCESS program’s list, include behavioral health firm SonderMind; Limbic, a company making an AI voice agent for therapy; Cadence Solutions, which makes a tool to support hypertension management; and continuous glucose monitor maker Dexcom.
CMS Administrator Dr. Mehmet Oz said the two programs allow technologies to more quickly move through the CMS and the FDA “so you don't have to fight multiple gauntlets to get the government to support your endeavors.”
The ACCESS program is limited to traditional Medicare. The CMS said payers representing Medicare Advantage, Medicaid and private health insurance plans have agreed to adopt a payment structure aligned with ACCESS, with some examples including Blue Shield of California, Cigna, CVS Health and UnitedHealthcare.
