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For over a decade, stakeholders across the healthcare industry have told a story of transformation. The healthcare industry has daydreamed about value-based care. We’ve nodded along (and sometimes nodded off) at conferences as visions of transformation were illustrated with elaborate slide decks, and applauded pilot programs that promise to finally—finally—align payment with patient outcomes. And yet, when it comes time to truly tie reimbursement to whether a patient’s blood pressure goes down or whether their blood sugar level improves, progress—and participation—have lagged. The concerns are familiar: patient behavior is unpredictable, social determinants are outside our control, outcomes are too hard to measure, and the risk is too high.
Over the last year, there have been echoes out of Washington that leaders were busy developing a new generation of payment models. Now, the Centers for Medicare & Medicaid Services (CMS) has articulated a model reflecting the administration’s vision to improve patient well-being using technology. On December 1, 2025, the CMS Innovation Center announced the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model—a 10-year voluntary program launching July 1, 2026 that does something no major Medicare initiative has done before: it pays providers based on whether patients actually get healthier. CMS will measure performance through biomarkers such as blood pressure, HbA1c, lipids, weight, and validated Patient-Reported Outcome Measures (PROMs) for pain, mood, and function.