Medicare launches ACCESS program to fund AI-driven chronic care management
Pair Team among 150 pilot participants in historic initiative that creates first federal mechanism to reimburse AI agents for patient monitoring and care coordination
The Centers for Medicare & Medicaid Services has launched the ACCESS program, a ten-year initiative designed to test a novel payment model that rewards health outcomes rather than service volume. Officially going live on 5 July, the program introduces a mechanism for the first time to pay for AI agents that monitor patients between visits, coordinate referrals and manage medication adherence.
The ACCESS initiative, which stands for Advancing Chronic Care with Effective, Scalable Solutions, targets chronic conditions such as diabetes, hypertension, obesity, depression and anxiety. By leveraging automated care, the program aims to address social determinants of health, including housing and food insecurity, through outcome-based management.
Pair Team, a healthcare company founded by Neil Batlivala, was selected as one of 150 participants to pilot the program. The company, which employs roughly 850 clinical professionals and serves patients with unstable housing or food insecurity, recently deployed a voice AI agent named Flora to handle patient interactions.
Program architects Abe Sutton, Director of the CMS Innovation Center, and Jacob Shiff, Chief AI and Technology Officer, are former startup operators who joined the agency under the Trump administration. Their background influenced the program's design to favour outcome-based payments and direct-to-consumer enrollment, reflecting a push for competition in the sector.
CMS is paying less per patient per month than many participants anticipated, a structure designed to incentivise lean, AI-first operations over traditional human-heavy models. Batlivala describes this lower reimbursement rate as a feature rather than a bug, noting that the economics only work if organisations run a lean, AI-first operation.
Pair Team reports that one in four hospital visits and one in two emergency department visits are avoided when patients are in their care model. The company has partnerships in place that give it access to roughly 500,000 potential patients and aims to reach a million within three years.
Despite the focus on health technology, the ACCESS program has barely registered outside health tech trade press. Healthcare investors have been watching closely as digital health funding hit its highest quarterly total since the pandemic, with AI companies capturing the bulk of the investment.
