The promise and uncertainty of Medicare's ACCESS model

CMS's new ACCESS payment model is a novel approach in how Medicare pays for chronic-disease management: recurring, condition-specific payments tied to clinical improvement, rather than billing for discrete encounters or tightly defined remote-monitoring activities. The promise is straightforward, more reimbursement for technology-enabled longitudinal care and more choice and competition for patient care. But ACCESS leaves many questions unanswered about payment levels, how quality is measured, risk adjusted, and how these patients' facing technology-enabled services coordinate care with the traditional delivery systems. Whether ACCESS strengthens primary care will depend on the details.