ACCESS Demo: The Future?
For my entire career (and that's a really long stretch), insurers, the government, and medical groups have been trying to figure out how to pay for better outcomes. The problem is that no one really knows how to define 'better'. Here we go again. The Centers for Medicare & Medicaid Services (“CMS”), through the CMS Innovation Center (“CMMI”), has announced the ACCESS Model—Advancing Clinical Care, Equity and System Sustainability , a demonstration model that aims to create an outcomes-based payment pathway for chronic-condition management, care coordination, and health-related social needs (“HRSN”) integration. The ACCESS Model claims to be different from other models. This is because it establishes a structure that allows a wide range of Medicare Part B-enrolled organizations—including physician practices, digital chronic-care platforms, home-based providers, and community-supported care organizations—to receive Medicare payments tied directly to clinical and equity-related…
