The CMS ACCESS model is live—are commercial teams ready?

For years, one of the biggest barriers to digital health adoption wasn’t accessing or understanding technology, but getting paid for utilizing that tech.

Healthcare organizations have long recognized the value of remote monitoring, digital care management, and virtual care programs, but payment models weren’t initially designed to reward providers that leveraged them. However, ongoing public health policy shifts are aiming to modernize those models.

The Centers for Medicare & Medicaid Services’ (CMS) new ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) model introduces an outcomes-based payment approach that encourages providers to adopt technology-supported care for chronic disease management. Rather than paying for individual services—as in a fee-for-service model—the value-based ACCESS model boosts reimbursement to organizations that improve measurable outcomes for Medicare patients across common chronic conditions such as hypertension, diabetes, musculoskeletal pain, and depression.

For software and IT companies, medical device manufacturers, biopharma orgs, and others selling into the healthcare space, ACCESS’s implementation in July 2026 likely signals new investment opportunities and shifts in demand worth digging into.

Whether you’re prioritizing buyers by readiness or commercial opportunity, or trying to understand end-user consumers, here are some tips for more confidently navigating the evolving digital health market under ACCESS.

Finding providers that are ready to buy

Healthcare marketers often struggle to separate accounts that are simply interested in technological innovation from those with the incentive and infrastructure to implement it. Providers voluntarily operating under the ACCESS model are actively pursuing technology-enabled care, making them strong targets for commercial teams.

CMS’ list of accepted ACCESS applicants is a good place to start a search for organizations dedicated to improving Medicare patients’ chronic disease outcomes through technology. By May 2026, more than 150 applicants had already been accepted to the program.

Organizations participating in the ACCESS model are more likely to be investing in technology-enabled care systems and tools—including remote monitoring and other digital-first programs—and focused on value-based care, rather than fee-for-service care. They’re also likely to be treating large Medicare populations with qualifying chronic conditions.

With these insights alone, healthcare marketers have a strong baseline for segmentation and engagement strategies. However, the accepted applicant list may not be exhaustive, and it doesn’t capture providers seeking future acceptance into the program.

For a more comprehensive picture of buying intent, commercial teams should derive insights from a variety of data sources, including procedure and diagnosis claims, reference and affiliations data, and existing technology installations. Less-publicized factors like financial performance, the age of existing vendor contracts, and impending M&A activity can all influence an organization’s readiness to engage with new vendors.

Prioritizing accounts by treatment volumes

Capitalizing on shifts in care spurred by the ACCESS model requires a clear view of provider activity. Tracking volumes of patients and treatments associated with your prospects and accounts is always a good strategy; under ACCESS, it bears paying especially close attention to those rewarded by the new model:

• Which providers treat the largest populations of patients with qualifying conditions, like diabetes, hypertension, or chronic pain? Consider how your company can help them keep those patients engaged or grow service lines associated with higher ACCESS reimbursement.
• Where do Medicare populations most overlap with ACCESS target conditions? Providers serving these cohorts are high-value targets for vendors supporting integrated, technology-enabled care.
• Which organizations have sufficient patient base to generate meaningful ROI from digital health investments? Providers with high patient volumes within ACCESS-related therapy areas may be better poised to say “yes” to a digital health investment than those that would require significant support to recruit and retain those patients.
• Which health systems are positioned to implement or expand technological solutions across multiple service lines? Financially robust, centrally managed networks with ample patient volumes across relevant service lines can be lucrative targets for wide-ranging enterprise deals, while smaller or more horizontally aligned networks may require more engagement and buy-in from individual service line leaders.

Provider- and patient-level data and analytics are the keys to identifying organizations with both clinical need and commercial potential. To find the largest opportunities in digital health, you should partner with a vendor offering multiple types of high-quality, well-curated data.

Identifying digital health consumers

The implementation of the ACCESS model continues healthcare’s shift from a provider-centric process to one oriented around patient experience and preference.

Modern patients are increasingly active participants in technology-supported care through the use of wearables and connected devices, mobile applications, and virtual engagement across a variety of channels. Through ACCESS, CMS aims to reward providers that enable and encourage patient-centered digital care using remote monitoring, telecare, online medication management, and other digital interventions.

Any commercial team selling into digital health can sharpen their messaging and value proposition by better understanding the end-user consumers most likely to engage with their solutions. But for direct-to-consumer companies, this intelligence is a must-have.

Procedure and diagnosis claims, referral data, digital channel engagement data, and other consumer behavior insights can help you understand the real people benefitting from your solution. Once you’re intimately familiar with the patients at the heart of your market, you can more effectively target and engage them—and their providers.

Data types that signal intent and value

Procedure and diagnosis claims data can indicate relevant treatment volumes and likely technology usage, highlighting growth opportunities, resource barriers, and/or organizational readiness for new or upgraded tools. High-quality claims data should enable examination of trends at the network, facility, and healthcare professional level for maximum precision.

Reference and affiliation data offers a look into the structure and operations of a prospective buyer: Who the decision-makers are, how influence flows between service lines, and for what procedures and conditions are patients being brought in—or referred out. Any of these details can help sales and marketing professionals better understand an account’s strengths and weaknesses as well as aid in finding the best point of contact to close or influence a deal.

Technology installation data reveals software and hardware utilization within specific facilities, physician groups, or networks, revealing high-value prospects along with competitor market share among certain firmographic, geographic, or procedural classifications. This data provides the most direct indication of a prospective buyer’s current relationship with technology, enabling commercial teams to build stronger cases for their own offerings based on the buyer’s existing tech stack.

The broader category of population intelligence combines demographic, geographic, health interest, and social determinants of health data to deliver deep insights into consumer behaviors and market segments. With this data, it’s easier to target precise audiences, personalize messaging, and engage consumers using the most impactful channels.

Learn more

Finding success in the wake of the ACCESS model launch means keeping up with the new direction of healthcare, and understanding the procedures, diagnoses, technologies, and patients driving value- and outcomes-oriented care.

As healthcare organizations are further incentivized to adopt technologies and digital methodologies that improve outcomes, companies selling into this space need the right data to identify the providers most ready to buy, prioritize those with the greatest commercial opportunity, and understand the consumers most likely to benefit from digital health innovations.

Definitive Healthcare’s solutions combine insights from multiple, high-quality data sources with powerful analytical tools, all designed to work within the systems and workflows your company already relies on. Want to see how our data and analytics can help you sell more effectively in a shifting care environment? Sign up for a free trial today.