Vital Signs with Jacob Effron and Nikhil Krishnan Ep 65: CMMI Leaders on ACCESS Model Launch, Drug Pricing Strategy, and the Future of Technology Enabled Care
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Dec 8, 2025 
Abe Sutton, the Director of CMMI, and Jacob Shiff, Chief AI & Technology Officer at CMMI, dive into the innovative ACCESS model designed to transform chronic care for Medicare patients. They discuss how this outcome-aligned payment structure fills a gap for original Medicare beneficiaries, ensuring they have access to technology-enabled treatment. The duo emphasizes the model's potential to encourage innovation while detailing how AI can enhance care delivery. Additionally, they explore regulatory challenges and the importance of balancing safeguards with tech adoption.
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ACCESS Closes Medicare Digital Care Gap
- ACCESS fills a Medicare gap by paying for outcome-driven, technology-enabled chronic care rather than activity-based visits.
- This expands access to digital therapeutics for original Medicare beneficiaries who were previously excluded.
Pay For Outcomes, Not Activity
- Avoid fee-for-service billing for abundant digital care because it inflates utilization and costs.
- Use outcome-aligned payments to reward improvement instead of volume for technology-enabled care.
How Organizations Earn Under ACCESS
- Enroll as a Medicare provider group and deliver blended virtual and in-person interventions under ACCESS to earn predictable monthly payments.
- Capture baseline measures and only earn full payment when patients meet measurable improvement goals.