CMS Approves Over 150 Digital Health Companies for Landmark Chronic Care Experiment Linking Payment to Patient Outcomes

The Centers for Medicare & Medicaid Services (CMS) has approved more than 150 digital health companies to participate in its new ACCESS experiment — a groundbreaking chronic care program that ties reimbursement directly to patient health outcomes rather than volume of services. The initiative represents one of the most ambitious federal efforts to integrate technology-driven care management into Medicare’s payment infrastructure and could reshape how millions of Americans with chronic conditions receive ongoing treatment.

The ACCESS (Advancing Care Coordination and Expanding Support Services) experiment represents CMS’s most substantial bet yet on the digital health sector’s capacity to manage chronic illness at scale. For years, the federal government has sought ways to bend Medicare’s cost curve while simultaneously improving care for beneficiaries with conditions like diabetes, hypertension, heart failure, chronic obstructive pulmonary disease, and behavioral health disorders. These conditions disproportionately drive hospitalizations, emergency department visits, and long-term disability — outcomes that impose enormous burdens on both patients and the federal budget. By opening the door to more than 150 technology companies, CMS is signaling that it views digital tools — including remote patient monitoring, AI-powered care coordination, virtual care platforms, and app-based patient engagement — as potentially transformative rather than merely supplementary to traditional clinical workflows.

The outcome-aligned payment structure is the experiment’s most consequential design feature. Under traditional Medicare fee-for-service, providers are reimbursed for each service rendered regardless of whether a patient’s condition actually improves. This system has long been criticized for incentivizing volume over value. CMS has spent the better part of two decades attempting to shift toward value-based care through a succession of models — from Accountable Care Organizations (ACOs) launched under the Affordable Care Act to bundled payment initiatives and the Medicare Shared Savings Program. However, progress has been uneven. A 2024 analysis by the Medicare Payment Advisory Commission (MedPAC) found that while ACOs have generated modest savings in some cases, the broader transition away from fee-for-service has been slower than policymakers hoped. The ACCESS experiment’s explicit linkage of digital health company payments to clinical outcomes — such as reduced HbA1c levels for diabetic patients or lower blood pressure readings for those with hypertension — could provide the clearest test yet of whether technology-enabled care management can deliver measurable results when financial incentives are properly structured.

The selection of more than 150 participants also raises important questions about program oversight, data privacy, and equity. Digital health solutions have historically faced scrutiny over their accessibility to older, lower-income, and rural populations who may lack broadband access or digital literacy. CMS will need to demonstrate that the ACCESS experiment does not inadvertently widen existing health disparities. Additionally, the sheer number of participating companies will require robust evaluation frameworks to determine which approaches genuinely improve outcomes versus those that simply capture favorable patient populations. Industry observers will be watching closely for the specific performance benchmarks CMS sets, the data reporting requirements imposed on participants, and the timeline for preliminary results — all of which could influence future rulemaking around Medicare’s permanent coverage of digital chronic care management services.

Looking ahead, the ACCESS experiment could have far-reaching consequences beyond the companies directly involved. If the model demonstrates that digitally-enabled, outcome-linked care meaningfully reduces costs and improves health metrics, it could accelerate CMS’s broader push to make value-based payment the default rather than the exception across Medicare. Conversely, if results are mixed or if implementation challenges prove significant, it could slow momentum for integrating commercial digital health platforms into public insurance programs. The experiment’s findings may also influence state Medicaid programs, many of which look to CMS innovation models as templates for their own reforms. With Medicare enrollment projected to reach approximately 80 million beneficiaries by 2030 as baby boomers continue aging into the program, the stakes for finding scalable chronic care solutions have never been higher.