Vital Signs with Jacob Effron and Nikhil Krishnan Ep 65: CMMI Leaders on ACCESS Model Launch, Drug Pricing Strategy, and the Future of Technology Enabled Care
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Dec 8, 2025 
Abe Sutton, the Director of CMMI, and Jacob Shiff, Chief AI & Technology Officer at CMMI, dive into the innovative ACCESS model designed to transform chronic care for Medicare patients. They discuss how this outcome-aligned payment structure fills a gap for original Medicare beneficiaries, ensuring they have access to technology-enabled treatment. The duo emphasizes the model's potential to encourage innovation while detailing how AI can enhance care delivery. Additionally, they explore regulatory challenges and the importance of balancing safeguards with tech adoption.
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Clear Attribution Via Condition Tracks
- ACCESS avoids overpaying multiple parties by tying payments to distinct condition-specific outcomes and letting clinicians hold global cost risk.
- If separate vendors each drive valid outcomes for different conditions, paying multiple providers is acceptable.
Design Multi-Year Targets Carefully
- Structure patient engagements as an initial 12-month period with targets of improvement or guideline achievement.
- Re-baseline in follow-up periods so incentives sustain continued improvement or maintenance of goals.
Use All Effective Tools To Hit Outcomes
- Embrace creative levers like medications or devices if they help achieve clinical goals; ACCESS does not rigidly assign cost accountability.
- Monitor outcomes closely and be prepared for model updates if unintended behaviors arise.