The CMS news this week may signal a significant turning point for virtual programs and value-based care (VBC). Its new ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model introduces a 10-year test that will pay for measurable patient outcomes under Medicare Part B by supporting technology-enabled chronic care management at scale.
On the face of it, this is great news for Xealth, our provider customers, and our vendor partners. We have been waiting for the day that we are all recognized for the important role we play in helping people manage their own health, including chronic conditions.
But what, exactly, is the role of the provider? Did we miss the part of the announcement where CMS outlined the hoops providers need to jump through in order to get paid? What will the reporting be, how will the data flow, will there be tedious reporting requirements? How can technology make reporting easier?
And, ultimately, how much can doctors be reimbursed for co-managing their patients who are enrolled in these programs?
Beginning in July 2026, ACCESS will initially focus on four high-impact condition areas that collectively affect more than two-thirds of Medicare beneficiaries:
- Early cardio-kidney-metabolic conditions: hypertension, dyslipidemia, obesity, and prediabetes
- Established cardio-kidney-metabolic conditions: diabetes, chronic kidney disease, heart disease
- Chronic musculoskeletal pain
- Depression and anxiety
While we are still awaiting key details, the direction is clear. CMS is opening the door to a fully integrated, tech-enabled ecosystem that brings together in-person, virtual, and digital health resources to advance patient outcomes. As CMS Administrator Dr. Mehmet Oz noted, “ACCESS introduces a way of paying for care that focuses on results. It offers clinicians a new predictable payment option, giving them the flexibility to use digital tools that help people take charge of their health.”
Xealth’s Role in the ACCESS Era
Xealth was founded to help health systems orchestrate digital health at scale. Today, we are the leading platform for organizing, integrating, activating, and analyzing digital health initiatives across clinical lines. Our technology allows providers to seamlessly prescribe digital tools directly within their workflows and track engagement and outcomes. Additionally, our real-world evidence shows that when a patient’s primary care provider suggests that they use digital tools, patients are 3-5x more likely to use them than when the tool vendor or payer suggests use of the tool.
ACCESS places new emphasis on documenting and defending outcomes over time—and on independently validating the performance of participating providers. Xealth is well positioned to support this analytics flow. Our ability to unify clinical data (including the FHIR-based information needed for longitudinal outcomes analysis), surface insights within provider workflows, and connect digital tools back to the referring PCP strengthens the very co-management model ACCESS envisions.
Data is presented in an integrated manner to make it actionable. As CMS shifts payment toward demonstrated, evidence-based improvement, Xealth’s Patient Outcomes capabilities become an increasingly valuable component of a system’s ACCESS strategy.
Samsung’s recent acquisition of Xealth underscores the strength, maturity, and scalability of this model. With Samsung’s support, we are expanding our capabilities and accelerating the impact we can deliver for health systems, partners, and patients.
As a Providence spinout, Xealth now supports more than two dozen of the nation’s leading health systems, powering thousands of programs and demonstrating measurable results across a wide range of clinical areas. Health systems using Xealth are already equipped to meet the expectations of a more digitally engaged patient population. Now, they are well positioned for the opportunities created by ACCESS.
CMS also announced plans to launch an “ACCESS Tools Directory” to identify optional digital tools and devices. This is an encouraging development. Xealth has spent years building and curating one of the most comprehensive digital health ecosystems in the market—based entirely on the needs and requests of leading health systems. Just as importantly, Xealth is one of the few platforms that can operationalize, activate, and measure utilization across these programs in a standardized, system-wide manner.
Looking Ahead
We also applaud ACCESS’s focus on paying for documented, evidence-based outcomes—especially in areas where long-term preventive benefit has historically been difficult to reimburse. As the model matures, we encourage CMS to continue tracking and publicly reporting the effectiveness of ACCESS participants to support transparency and continuous improvement. Broadly, ACCESS is good for the industry: it strengthens alignment for patients, payers, and providers, as long as outcomes are made publicly available and clinical data continues to flow back to the patient’s core PCP for coordinated care.
Perhaps most importantly, ACCESS will broaden availability of digital tools that historically were accessible only via self-pay or limited commercial pathways. As outcome-aligned reimbursement expands, we expect utilization to rise significantly, particularly in the early years of the model. This is a win for patients, for care teams, and for health systems seeking more effective ways to manage chronic disease at scale.
ACCESS represents a long-awaited alignment between clinical innovation, patient engagement, and reimbursement. Recognizing digital’s role in expanding care teams and empowering patients and providers. Patients will feel seen and clinicians will hopefully experience some needed relief. We are proud that Xealth’s platform, our health system partners, and our curated ecosystem of digital health solutions are well prepared to help deliver on this moment.