OT opportunities in CMS ACCESS Model for chronic care

The Centers for Medicare & Medicaid Services (CMS) recently introduced a voluntary Medicare Part B payment initiative to improve care for individuals with chronic conditions through technology-enabled, outcome-driven approaches. The Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model seeks to bridge the gap between traditional fee-for-service systems and modern, technology-supported care coordination and delivery.

Digital technologies are transforming how care is delivered, providing continuous support beyond the provider’s office: telehealth software that enables patients to interact with providers from home; wearable devices that monitor sleep, heart rate, movement, blood sugar, and adherence to therapy protocols; and mobile apps that coach individuals on lifestyle changes that can benefit their health and well-being. These technology-supported services are especially valuable for people in communities with limited local care options. The goal of the ACCESS model is to leverage these technology tools to enhance patient engagement, improve outcomes, and expand access to care for people with targeted conditions, including:

• Early cardio-kidney-metabolic conditions such as hypertension, high cholesterol, obesity, and prediabetes
• Cardio-kidney metabolic conditions such as diabetes, chronic kidney disease, and heart disease
• Chronic musculoskeletal pain
• Depression and anxiety

How it works

Participating organizations must be accepted into the model by CMS, be Medicare Part B–enrolled, and have a designated Medicare-enrolled Medical Director to oversee care coordination. Medicare Part B beneficiaries can then sign up directly with participating ACCESS organizations or enroll after referral from their primary care provider.

Participating organizations will be expected to deliver integrated, technology-supported care. They will receive Outcome-Aligned Payments (OAPs) tied to measurable health improvements, such as improved blood pressure, HbA1c, lipids, weight, or validated Patient-Reported Outcome Measures (PROMs) for pain, mood, and function. Care can be provided in-person, virtually, asynchronously, or through other technology-enabled methods, as clinically appropriate, and may include one or more of the following focus areas:

• Clinician consultations
• Lifestyle and behavioral support (nutrition, exercise, smoking cessation)
• Therapy and counseling
• Patient education and care coordination
• Medication management
• Ordering and interpreting diagnostic tests and imaging
• Use or monitoring of FDA-authorized devices, including wearables and software-enabled tools

Opportunities for OT

The ACCESS Model emphasizes integrated, patient-centered care, creating a strong opportunity for occupational therapy (OT) involvement. OT practitioners are uniquely positioned to address functional, behavioral, and environmental factors that influence chronic disease management and health outcomes. By leveraging OT expertise, participating organizations can improve patient outcomes, enhance engagement, and achieve CMS-defined performance targets.

ACCESS organizations may benefit from employing or contracting with OT practitioners to:

• Help meet performance thresholds through evidence-based OT interventions
• Offer remote therapeutic monitoring (RTM) to monitor therapy adherence and outcomes
• Deliver training on devices and software that support patient engagement

OT private practices may also have an opportunity to participate directly as an ACCESS organization if they have the infrastructure necessary to meet participation requirements.

For more details, review CMS’s detailed FAQ, or to express interest in becoming a participating organization, complete the Model Interest Form.

Requests for Applications will be available soon and are due by April 1, 2026.