Outcome-Aligned Payments for Technology-Enabled Care

This document is a technical report detailing the new Outcome-Aligned Payments (OAPs) model introduced by the CMS Innovation Center, aimed at improving chronic disease care in Medicare. It outlines the challenges faced by clinicians in managing chronic diseases and the potential of technology to enhance care delivery. The report identifies three key themes: the need for improved care quality and access through technology, the limitations of current fee-for-service payment models, and the necessity for new payment options that incentivize high-value care. The ACCESS model, launching in July 2026, will reward organizations based on measurable health outcomes rather than activities, allowing for flexible care delivery methods. It includes four clinical tracks for common chronic conditions and emphasizes integrated care management. The report also discusses expected savings from improved clinical control and outlines risk mitigation strategies to prevent issues such as selective enrollment and overtreatment. Overall, the ACCESS model aims to modernize chronic disease management in Medicare through innovative payment structures.