Medicare launches AI-focused payment model with 150 participants
Original: Medicare’s new payment model is built for AI, and most of the tech world has no idea
Why This Matters
First federal payment model enabling AI-driven healthcare at scale through outcome-based reimbursement
Medicare's ACCESS program, launching July 5, tests outcome-based payments for AI-driven healthcare over 10 years. 150 organizations including Pair Team will manage chronic conditions like diabetes and hypertension, earning payments based on patient health improvements rather than time spent.
The Centers for Medicare & Medicaid Services selected 150 participants for ACCESS (Advancing Chronic Care with Effective, Scalable Solutions), a 10-year program testing AI-driven medical care at federal scale. The program launches July 5 and covers diabetes, hypertension, chronic kidney disease, obesity, depression, and anxiety. Unlike traditional Medicare that reimburses based on clinician time, ACCESS pays for health outcomes like lower blood pressure or reduced pain. This creates the first mechanism to pay for AI agents that monitor patients between visits, coordinate care, and manage medications. Participants include AI doctor startups, virtual nutrition therapy providers, connected device companies, and wearable makers like Whoop. Pair Team, a participant that serves patients with chronic conditions and social challenges like housing instability, has built toward this model for five years, employs 850 clinical professionals, and generates nine-figure revenue.