Navigating CMS's ACCESS Model: How The Garage Empowers Better Outcomes for Medicare Patients

Overview of the CMS ACCESS Model

The Centers for Medicare & Medicaid Services (CMS) is launching the ACCESS Model-Advancing Chronic Care with Effective, Scalable Solutions-on July 1, 2026. This voluntary, 10-year Medicare Innovation Center model is designed to transform how chronic care is delivered and managed for conditions such as diabetes, hypertension, chronic pain, and depression.

ACCESS moves beyond traditional fee-for-service reimbursement by linking incentives to performance and outcomes. While CMS has not yet finalized specific payment formulas or benchmarks, the direction is clear: success under ACCESS will require coordinated care, measurable improvement, and the ability to operationalize equity at scale. Technology, interoperability, and patient engagement will be foundational-not optional.

What Is the ACCESS Model?

ACCESS is built to support proactive, patient-centered chronic care. The model encourages providers to address clinical, behavioral, and social needs in a coordinated way, using digital tools and data-driven insights to improve outcomes over time.

Rather than focusing solely on compliance, ACCESS emphasizes performance-rewarding organizations that can demonstrate improvement across defined outcome domains as CMS finalizes measurement and reporting requirements. Participating organizations will need integrated data, execution-ready workflows, and scalable operating models to succeed.

This is where The Garage plays a critical role-helping organizations move from ACCESS participation to ACCESS performance.

Eligibility:
ACCESS is available only to Original Medicare fee-for-service beneficiaries. Medicare Advantage enrollees are not eligible to participate under the model.

Why CMS's ACCESS Model Matters

CMS's ACCESS Model is transforming how healthcare is delivered, coordinated, and reimbursed across the U.S. It sets a new expectation: outcomes must be proven, equity must be measurable, and care must be scalable. By linking access to measurable outcomes, the model ensures that the right care reaches the right people while enabling innovation and improved population health.

The model supports:

• Equity and Coverage: Programs like Medicare, Medicaid, and CHIP ensure vulnerable populations-including seniors, low-income individuals, and people with disabilities-can access essential services.

  Bridge operationalizes equity by embedding social context directly into care workflows. Bridge integrates SDOH insights to help providers identify and address barriers such as transportation, housing, and food insecurity-while connecting patients to community-based resources - so interventions occur in real time, not after the fact.

• Quality and Outcomes: Providers are incentivized to deliver timely, effective, and patient-centered care, improving health outcomes and reducing disparities.

  Bridge enables evidence-based care by unifying clinical, lab, and longitudinal patient data into a single, actionable view, supporting timely interventions, medication reviews, and continuous symptom monitoring to improve outcomes and reduce disparities.

• Cost Efficiency: Defined access rules manage healthcare spending, prevent unnecessary utilization, and support value-based care.

  Bridge delivers cost efficiency by removing friction from care delivery through AI-enabled automation and integrated data workflows:

  • AI-driven agents (BlazeLink, BlazeSpeaks, BlazeSync) automate care coordination, routine outreach, and real-time communication-reducing administrative burden while allowing care teams to focus on high-impact patient needs.
  • Centralized data integration enables providers to access comprehensive patient information from EHRs, labs, claims, SDOH sources, and medication histories. This reduces duplicative testing, unnecessary referrals, and gaps in care.
  • Automated eligibility and utilization management align services to patient need and CMS guidance, helping organizations reduce overuse while maintaining compliance.
  • Population health analytics enable organizations to proactively identify high-risk patients, prioritize interventions, and allocate resources where they matter most, improving outcomes while controlling costs.
  • Support for value-based contracts: Bridge tracks performance against quality measures and outcome targets, turning ACCESS requirements into measurable, manageable actions that help providers maximize incentives and reduce downside risk
  • Scalable workflows: Scalable, repeatable workflows reduce variation, support consistency, and allow organizations to grow ACCESS participation without adding operational complexity.

  By combining advanced technology, robust data integration, and practical workflow automation, Bridge helps organizations reduce operational friction while delivering high-quality, patient-centered care at scale.

• Data-Driven Insights: ACCESS success depends on turning large-scale claims, clinical, and outcomes data into actionable intelligence that informs population health strategy and continuous quality improvement.

  Bridge aggregates and harmonizes data from a trusted ecosystem of partners-Johns Hopkins ACG for risk stratification, IMO Health for standardized clinical terminology and coding accuracy, Health Gorilla for comprehensive longitudinal patient records, Labcorp for timely chronic disease lab results, and Surescripts for medication history and e-prescribing. Together, these integrations deliver a unified, actionable view of patient risk, care gaps, and intervention opportunities-enabling providers to make confident, data-driven decisions and continuously improve outcomes under ACCESS.

• Support for Value-Based Care: ACCESS reinforces the shift to value by rewarding coordinated care, prevention, and effective chronic disease management.

  Bridge supports seamless participation in value-based care by enabling providers to track outcomes, coordinate care across settings, and align day-to-day workflows with performance incentives.

How The Garage Operationalizes ACCESS Across the Care Continuum

• Assessment & Analytics: Providers assess clinical and social data, stratify risk, and identify care gaps to target interventions where they will have the greatest impact.

  Bridge brings together data from EHRs, labs, claims, and social determinants sources to support holistic patient assessment. This unified view allows organizations to stratify risk, identify unmet needs, and prioritize outreach-ensuring resources are focused on the patients who need them most.

• Care Coordination & Communication: Seamless collaboration across care teams ensures patients receive consistent follow-up, timely referrals, and smooth transitions across the continuum of care.

  The Garage's AI-powered suite is transforming care delivery and operational efficiency across the healthcare continuum. BlazeLink addresses the complexity of payer contract management and 340B optimization, ensuring revenue integrity and compliance while unlocking savings opportunities. BlazeSpeaks brings intelligence to the point of care, surfacing real-time prompts and actionable insights that help clinicians close gaps and improve quality scores during patient encounters. Complementing these, BlazeSync acts as a digital assistant for care managers-automating outreach, follow-ups, and documentation, reducing manual workload by hours each day, and delivering guaranteed ROI in under three months. Together, these agents empower care teams, streamline workflows, and drive measurable outcomes for providers and payers alike.

  Beyond AI, The Garage turns integrated data into action. Bridge translates insights into practical, repeatable workflows that empower care teams to deliver seamless, patient-centered care-without adding complexity to already stretched operations.

• Unified EHR connectivity Bridge integrates patient records across multiple EHRs, giving care teams a single, up-to-date view of medical history, medications, lab results, and care plans. The result is fewer gaps, less duplication, and more confident clinical decision-making.
• Streamlined referral management: Referrals are automated, tracked, and closed-loop-ensuring timely follow-up and accountability so patients don't fall through the cracks.
• Workflow and task automation: Bridge operationalizes care delivery by enabling teams to assign, track, and complete tasks efficiently, supporting collaborative care, transparency, and shared accountability across roles.
• Secure communication and documentation: Care teams can securely message, share documents, and coordinate within Bridge-supporting HIPAA compliance while accelerating decisions and reducing reliance on fragmented tools.
• Patient outreach and engagement: Automated reminders, follow-ups, and education keep patients informed and engaged between visits-supporting adherence, continuity, and better outcomes.
• Interoperability beyond the four walls: Bridge connects seamlessly with labs, pharmacies, community resources, and payers, ensuring information flows across the ecosystem and all stakeholders stay aligned.

  By combining AI-enabled automation with execution-ready workflows, The Garage helps organizations remove operational friction, scale coordinated care, and deliver high-quality, patient-centered outcomes-at enterprise scale.

• Clinical Management & Interventions: Evidence-based clinical management-including medication reviews, symptom monitoring, and behavioral health integration-is central to how The Garage helps organizations succeed under ACCESS. Bridge operationalizes these capabilities within everyday workflows, enabling care teams to stabilize patients, prevent complications, and improve long-term outcomes at scale.

  Bridge delivers timely clinical insights, longitudinal medication visibility, and integrated behavioral health support directly within care workflows-allowing providers to act earlier, intervene more effectively, and standardize care across populations. By embedding evidence-based protocols into daily operations, The Garage supports safer clinical decisions, more consistent interventions, and sustains outcomes across chronic conditions.

• Engagement & Education: Sustained outcomes under ACCESS depend on engaged patients. Bridge empowers individuals through self-management support, motivational interviewing, and active participation in personalized care plans.
  • Ignite, The Garage's telehealth application, enables secure virtual visits, direct messaging, and real-time access to care teams-helping remove geographic and access barriers. This is especially impactful for rural and underserved populations, where consistent touchpoints are critical to continuity of care.
  • Engage, The Garage's patient-facing engagement application, delivers personalized education, reminders, and digital tools that help patients track progress, set goals, and stay actively involved in their care journey. By putting actionable information directly in patients' hands, Engage supports adherence, accountability, and better outcomes.
• Social Support & Resources: Addressing social determinants of health is essential to achieving equitable outcomes. Bridge embeds SDOH screening and community resource connections directly into care workflows - addressing barriers such as transportation, housing, and food insecurity.

  By integrating Experian's SDOH data with Findhelp, providers can identify unmet needs and connect patients to trusted community resources-extending care beyond the clinical setting and supporting whole-person health.

  • Scalability & Sustainability: Repeatable workflows, automation, and interoperability enable organizations to deliver consistent, high-quality care to large patient populations over time.

    Bridge supports sustainable scale by combining tech-enabled care delivery with embedded social support-helping organizations expand ACCESS participation while maintaining equity, performance, and operational efficiency across diverse patient populations.

What We Know-and What We Don't (Yet)

CMS has not yet released:

• Final performance measures
• Payment benchmarks or risk-adjustment methodology
• Detailed technical and reporting specifications

ACCESS should be viewed as a flexible framework that will evolve as CMS issues additional guidance. Organizations that prepare early will be best positioned to adapt as details are finalized.

Preparing for ACCESS: Key Readiness Areas

To prepare for ACCESS, providers should assess and strengthen the following capabilities:

• Data interoperability and EHR integration
• Practical workflows for care coordination and documentation
• Patient engagement pathways
• Remote monitoring and virtual care connectivity
• Compliance and reporting infrastructure
• Staffing models to support technology-enabled care

How to Succeed Under ACCESS

Success under ACCESS will require strong outcome tracking, data analytics, and reporting capabilities. Organizations must be able to:

• Collect baseline clinical and social data
• Monitor patient progress longitudinally
• Document interventions and care coordination activities
• Report outcomes accurately and consistently to CMS

Platforms that operationalize these requirements, like Bridge, rather than layering on additional complexity, will be essential to sustained performance.

Risks and Challenges

While ACCESS is designed to expand access, success will depend on patient adoption of technology-enabled care, including remote monitoring, virtual visits, and digital engagement tools. Adoption may be uneven-particularly among older adults, rural populations, and individuals facing digital access barriers.

Social determinants of health (SDOH) will continue to influence outcomes. Addressing these challenges requires more than technology alone; it demands coordinated care, trust-building, proactive outreach, and a reliable connection to community resources.

While ACCESS is designed to improve access, success depends on patient adoption of tech-enabled care (remote monitoring, virtual visits, apps), which may be uneven, particularly among older, less tech-savvy, or rural populations. Social determinants of health (SDOH) challenges may impact outcomes; bridging that gap requires more than just technology, but also care coordination, trust-building, outreach, and resource linkage.

Getting Started & What's Next

• Eligibility: Original Medicare fee-for-service beneficiaries only (not Medicare Advantage)
• Information & Deadlines:
  • Request for Applications (RFA) release
    • RFA Release Status: CMS has indicated that the ACCESS Model Request for Applications (RFA) will be released in advance of the July 2026 start date, though a specific publication date has not yet been announced. Interested organizations are encouraged to register for ACCESS Model updates to receive notifications as guidance is released. Interested organizations are encouraged to sign up for the ACCESS Model Interest Form to receive alerts.
    • Application Deadline:
      • CMS has indicated that applications for the initial performance period beginning July 1, 2026, will be due in early 2026, with April 1, 2026, referenced as the anticipated deadline. Applications submitted after this date will be considered for future participation periods, including January 1, 2027.
      • Applications submitted after April 1, 2026, will instead be considered for participation beginning January 1, 2027.
  • CMS posting of full technical specs and outcome measures
    • Status: CMS has not yet released full technical specifications or the complete set of outcome measures for the ACCESS Model. Existing guidance and FAQs outline the model's intent and structure, but detailed measures, reporting requirements, and technical specifications are still under development and are expected to be finalized closer to-or following-the RFA release.
    • CMS guidance and FAQs describe the model design broadly, but detailed measures and technical requirements are still under development and are expected closer to the RFA release or as follow-on guidance.
    • CMS has indicated details are still being finalized and that technical guidance will accompany or follow the RFA.
  • Timeline for provider directory, vendor tools directory, interoperability, and compliance guidance
    • ACCESS Model Tools Directory
      • CMS has announced plans to introduce an ACCESS Model Tools Directory to highlight technologies that may support participation and compliance. While the concept has been outlined, an official launch date has not yet been published and is expected to align with the release of technical specifications or the RFA.
      • CMS has also indicated that formal interoperability and compliance guidance-covering data exchange expectations, reporting requirements, and regulatory alignment-will accompany or follow the release of technical details.
  • Interoperability & Compliance Guidance
    • CMS expects organizations to be compliant with applicable HIPAA, Medicare Part B enrollment, state licensure, and FDA requirements as part of participation.
    • Formal interoperability and compliance guidance specific to ACCESS (e.g., how data must be exchanged between participants and CMS) is expected with or after the technical specifications.

Providers should monitor these developments closely, as they will shape implementation strategies and stakeholder engagement.

Organizations preparing now-by strengthening data, workflows, and engagement strategies-will be best positioned to perform under ACCESS as details are finalized.

The Garage also works with organizations earlier in the process-helping leaders evaluate ACCESS participation, assess readiness, model operational implications, and determine whether and when participation makes strategic sense. From readiness assessment to execution at scale, Bridge supports organizations across the full ACCESS lifecycle.

To learn more about how The Garage helps organizations evaluate and operationalize ACCESS through Bridge, request more information here.