A new model goes live: ACCESS launches July 5
The headlineCMS's Innovation Center launches the ACCESS Model (Advancing Chronic Care with Effective, Scalable Solutions) on July 5, with a first cohort of roughly 150 participants. It's a 10-year national test that runs through mid-2036. Instead of fee-for-service billing, ACCESS pays Outcome-Aligned Payments: providers earn when patients with targeted chronic conditions hit measurable health improvements, reported to CMS through standardized APIs.
The launch tracks cover cardio-kidney-metabolic care (with a separate early-stage version), musculoskeletal, and behavioral health, spanning conditions like diabetes, hypertension, chronic kidney disease, obesity, depression, and anxiety. The first cohort leans heavily on digital health and ACO enablement companies, and CMS plans additional cohorts starting January 1, 2027 and quarterly after that.
The thing to understand is that ACCESS is designed to complement MSSP, not compete with it. CMMI has said that for 2026 and 2027 the model's payments will not affect ACO benchmarks or performance calculations, but starting in 2028 ACCESS payments get incorporated into benchmark and performance-year math. That 2028 line is the one to mark. If your attributed beneficiaries are also enrolled with an ACCESS participant, those payments eventually flow into the same financial picture you're managing.
Two moves worth making now: find out whether any ACCESS participants are already operating in your service area and touching your aligned population, and decide whether partnering with one, rather than watching from the sidelines, fits your chronic-care strategy before the next cohort opens in January.
Outcome-aligned payment turns entirely on clean, API-deliverable outcome data tied to the right beneficiaries, which is the same aligned-cohort reporting discipline we build for the ACOs on our platform.
The CY2027 PFS rule is coming, and the ACPT bill is still due
The headlineCMS is expected to release the CY2027 Physician Fee Schedule proposed rule in July, and it will carry the next round of MSSP methodology proposals with it. The backdrop is a benchmarking fight that cost ACOs real money. The Accountable Care Prospective Trend (ACPT), meant to protect ACOs from having their own savings used against them, did the opposite in 2024. CMS set the ACPT at 4.9 percent while actual Medicare cost growth ran 9.5 percent, so ACOs that held spending growth to 7.1 percent still owed penalties instead of sharing in savings. Industry analysts estimate that gap cost ACOs hundreds of millions in lost shared savings for 2024 alone, and more ACOs were exposed to the ACPT in 2025.
CMS leadership has separately signaled an aggressive direction. Medicare Director and Deputy Administrator Chris Klomp has said he wants to end unmanaged fee-for-service and push traditional Medicare and Medicare Advantage into direct competition.
When the rule drops, read the benchmarking section first. The questions that decide your economics over the next few years are whether CMS adjusts or zeroes out the ACPT, what it does with prepaid shared savings (only four of roughly 400 eligible ACOs qualified for those payments in 2026, a sign the current rules are too restrictive to use), and how the methodology treats high performers who keep beating their own benchmarks. None of this is academic. The ACPT example shows how a single trend assumption set in Washington can flip a well-run ACO from a savings check to a penalty.
We track benchmark and methodology mechanics closely for the ACOs on our platform, and we'll break down the MSSP provisions the day the proposed rule posts.
The HIPAA Security Rule rewrite is overdue, not gone
The headlineOCR's overhaul of the HIPAA Security Rule, the most significant update in over a decade, carried a May 2026 target for a final rule. That month has passed with no rule published. The proposal is not minor housekeeping. It would eliminate the long-standing "addressable" category that let organizations document their way out of certain safeguards, and make a list of controls flat-out mandatory: multi-factor authentication on every system that touches ePHI, encryption of ePHI at rest and in transit, annual penetration testing, network segmentation, a continuously maintained technology asset inventory, and tighter oversight of business associates.
OCR received roughly 4,700 comments and is still working through them, and the current administration's deregulatory posture makes the timing, and even the final scope, genuinely uncertain.
Treat this as a "when," not an "if," regardless of what OCR does next. If the rule finalizes close to its proposed form, the clock is short: an effective date about 60 days after publication and most requirements due within roughly 180 days after that, which is something like 240 days of total runway to roll MFA across every system, encrypt what isn't encrypted, stand up scanning and penetration testing, finish an asset inventory, and reissue BAAs across your vendor footprint.
For an ACO, the business-associate piece is the sharp edge. You aggregate PHI from every participant TIN and route it through vendors, so the rule's tightened BA expectations land on your whole data supply chain, not just your own systems. The asset inventory is the right first move, because every other requirement depends on knowing exactly what holds or touches ePHI.
These controls are already the baseline we operate under as a HITRUST-certified platform, so if you want a reference point for what "mandatory MFA and encryption everywhere" looks like in practice, ask us how we handle it.
What we're tracking next
- LEAD cohort notifications are expected this summer. CMS said it would notify accepted first-cohort applicants by mid-2026, and the no-risk implementation period for those selected runs September through December before Performance Year 1 begins January 1, 2027.
- MSSP PY2025 results are due later this year. PY2024 was the program's strongest on record, with about three-quarters of ACOs earning payments and roughly $2.5 billion in net savings, and PY2025 is the next read on whether that trajectory holds.
- MAHA ELEVATE awards for Cohort 1 are scheduled for a Notice of Award in fall 2026, with Cohort 2 opening on a separate cycle in 2027 for ACOs that want in on the chronic-disease funding.