Medicare’s new payment model is built for AI, and most of the tech world has no idea
There is no governmental mechanism to pay for an AI agent that monitors a patient between visits, calls to check in, coordinates a housing referral, or makes sure someone picks up their medication. ACCESS creates that mechanism for the first time.
AI Summary
Medicare's new ACCESS program, which launched July 5 as a 10-year pilot with 150 participants, introduces a payment model that rewards health outcomes rather than billable activities, creating the first mechanism to reimburse AI agents for patient monitoring between visits, medication coordination, and other support tasks. Traditional Medicare reimbursement is based on clinician time spent, leaving no way to pay for AI-driven interventions, but ACCESS allows organizations to receive predictable payments for managing conditions like diabetes, hypertension, and depression while earning full reimbursement only when patients meet measurable health goals. The program represents a significant shift toward outcome-based payment structures that could enable AI innovation in healthcare by removing previous barriers to reimbursement.