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10-Year CMS Program14 Major Health Plans Committed2027 Cohort Now Open

The ACCESS Model Is Here.
Partner With Sentinum
for 2027.

CMS's Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model pays technology-enabled organizations to deliver measurable chronic care outcomes for Medicare beneficiaries — with zero burden on ACO staff.

No Cost to Your ACOCMS-Backed Program30-Min Discovery Call
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The Program

What is the CMS ACCESS Model?

The Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model is a 10-year voluntary CMS Innovation Center model that pays Part B-enrolled technology organizations to manage chronic conditions for Medicare Fee-for-Service beneficiaries through outcome-aligned payments.

Critically, ACCESS is designed to work alongside ACOs — attributed Medicare beneficiaries can be concurrently enrolled in both MSSP or ACO REACH and the ACCESS Model. This means your ACO's population can benefit from structured chronic care coordination without any disruption to your existing program.

10 Years
Performance Period
July 2026 – June 2036
4
Clinical Tracks
MSK, BH, eCKM, CKM
Rolling
Applications
Open through 2033
14
Major Health Plans
Committed by 2028
~$100
Per Patient Per Year
CMS-paid co-management fees to ACO physicians
Clinical Tracks

Four Chronic Condition Tracks

Sentinum Health is applying to participate across all four ACCESS Model clinical tracks, covering the most prevalent chronic conditions in the Medicare population.

MSK

Musculoskeletal

Chronic back, hip, knee, neck, and upper extremity pain

Key Clinical Measures
Site-specific PROMs: Oswestry Disability Index (low back) · Neck Disability Index (neck) · QuickDASH (upper extremity) · KOOS JR (knee) · HOOS JR (hip) · PROMIS Physical Function & Pain Interference (multi-site)
Universal measures: NRS or PROMIS Pain Intensity — ≤2-point increase from baseline required · Patient Global Impression of Change (PGIC) at period end
BH

Behavioral Health

Depression and anxiety

Key Clinical Measures
Depression: PHQ-9 — documented improvement from individual baseline score
Anxiety: GAD-7 — documented improvement from individual baseline score
Overall function: WHODAS 2.0 (12-item) — World Health Organization Disability Assessment Schedule for overall functional status
eCKM

Early Cardiometabolic

Hypertension, dyslipidemia, obesity, prediabetes

Key Clinical Measures
Blood pressure: Control or improvement from individual baseline
Lipids: LDL-C — control or improvement from baseline
Weight / metabolic: BMI or weight — improvement from baseline · HbA1c for prediabetes patients
CKM

Advanced Cardiometabolic

Diabetes, chronic kidney disease (CKD), heart disease

Key Clinical Measures
Diabetes: HbA1c — target improvement or at-goal status from individual baseline
Kidney function: eGFR and kidney function markers — CKD progression monitoring
Cardiovascular: Systolic blood pressure control · LDL-C reduction · Weight management
Why ACOs

Why ACOs Should Partner With Sentinum

The ACCESS Model creates a unique window for ACOs to extend structured chronic care coordination to their attributed population — at no cost, no risk, and no burden.

18 Months
Benchmark Protection

Zero Risk to Your Shared Savings

CMS is temporarily excluding ACCESS spending from ACO cost benchmarks for the first 18 months of the program. Partnering with Sentinum does not count against your shared savings calculation during the evidence phase — your ACO absorbs the benefit with none of the benchmark exposure.

18-month benchmark exclusion

~$100
Per Patient Per Year

CMS Pays Your Physicians

Referring and primary care physicians earn a CMS co-management payment — approximately $100 per enrolled beneficiary per year — for reviewing Sentinum's AI-generated clinical updates. We generate the updates automatically. Your physicians earn the fees for a brief documented review.

10,000 enrolled patients = ~$1,000,000/yr to your physician network — paid by CMS, not by you.

~23%
Fewer Hospitalizations

Reduced Utilization Across Your Population

Structured care management at scale reduces avoidable ED visits, preventable hospitalizations, and unnecessary imaging. For ACOs accountable for total cost of care, this is the margin that matters most.

Multiple peer-reviewed meta-analyses show structured care management reduces hospitalizations by 19–26% (McAlister et al., JACC · Defined et al., CMAJ · Huntley et al., BMJ Open)

Proactive care coordination catches deterioration early — before it becomes an avoidable admission.

Zero
Administrative Burden

Nothing Added to Your Team's Plate

Sentinum handles everything: patient engagement, outcomes measurement, clinical update generation, and CMS reporting. You refer eligible beneficiaries. We manage the rest — from enrollment through outcomes reconciliation.

Your team refers. Sentinum does the rest.

Multi-Payer Alignment

14 Major Health Plans Have Committed

Under the ACCESS Payer Pledge, 14 leading health plans — representing 165 million Americans — have committed to adopt outcomes-based payment structures aligned with the ACCESS Model by January 1, 2028.

Arkansas Blue Cross and Blue Shield
Blue Shield of California
BCBS of Minnesota
BCBS of North Dakota
BlueCross BlueShield of Tennessee
CareFirst BlueCross BlueShield
Centene
Cigna
CVS Health
Devoted Health
GuideWell
Horizon BCBS of New Jersey
Humana
UnitedHealthcare

When commercial payers adopt ACCESS-aligned payment structures, Sentinum's infrastructure scales across your full attributed population — Medicare, Medicare Advantage, Medicaid, and commercial — without rebuilding anything.

Why Sentinum

The AI Infrastructure Built for ACCESS

Delivering measurable chronic care outcomes at population scale requires infrastructure purpose-built for it — intelligent patient engagement, automated outcome measurement, AI-powered care coordination, and seamless clinical escalation. Sentinum built this infrastructure from the ground up. Today it powers our CCM, RPM, PCM, and RTM programs. In 2027, it powers ACCESS.

AI-First, Operational Today

Our virtual nurse and AI care coordination platform is live and managing patient engagement across CCM, RPM, and PCM programs today. This is not a roadmap promise — it is production infrastructure serving patients right now.

Built and deployed. Not in development.

Proven Care Management Programs

We already operate CCM, PCM, TCM, RPM, and RTM — the clinical programs most directly analogous to ACCESS care coordination. We understand outcome measurement, patient engagement workflows, and CMS reporting requirements intimately.

CCM, PCM, TCM, RPM, RTM — all operational.

Zero Burden by Design

Our platform was architected from day one to require zero administrative burden on clinical staff. That same principle extends to every ACO partnership — your care management team identifies eligible beneficiaries and we take it from there.

You refer. We handle everything else.

FHIR-Ready Infrastructure

ACCESS requires FHIR R4 API connectivity for eligibility verification, beneficiary alignment, claims data integration, and outcome reporting. We are building to CMS's published specifications — including the BCDA API — starting now.

FHIR R4 · BCDA · Alignment API · Reporting API
How It Works

From Referral to Outcomes

A simple four-step model — your ACO identifies the patients, Sentinum delivers the program.

01

ACO Identifies Eligible Beneficiaries

Your care management team identifies attributed Medicare FFS beneficiaries with qualifying chronic conditions across the four tracks — MSK, behavioral health, early cardiometabolic, and advanced CKM.

Sentinum provides eligibility guidance and screening criteria to streamline this process.

02

Sentinum Enrolls and Engages

Sentinum handles enrollment, beneficiary engagement, care coordination, PROM collection, and clinical update generation — entirely through AI-powered automation. Beneficiaries receive structured, proactive outreach throughout their care period.

All patient engagement, documentation, and CMS reporting are managed by Sentinum.

03

Physicians Earn Co-Management Fees

CMS pays co-management fees directly to your referring and primary care physicians — approximately $30 per review, up to three times per year — for reviewing Sentinum's AI-generated clinical updates. A brief documented review in the EHR is all that's required.

~$100 per enrolled patient per year flows directly to your physician network from CMS.

04

Outcomes Improve. Benchmark Is Protected.

Sentinum reports outcomes to CMS and manages the semi-annual reconciliation process. Your ACO benefits from reduced downstream utilization across the enrolled population — with no impact on your shared savings benchmark for the first 18 months.

Improved chronic care management = fewer avoidable admissions = better total cost of care for your ACO.

Our Timeline

2027 Cohort Partnership Now Open

Sentinum Health is applying to become an ACCESS Model participant for the January 2027 cohort. We are actively building our ACO partner network now — ahead of program launch.

Sentinum Enters
January 2027
Quarterly Cohort Entry

Sentinum's target ACCESS Model entry date. Our ACO partner network is finalized. Beneficiary enrollment begins.

First Reconciliation
July 2027
Semi-Annual Outcomes Review

First semi-annual outcomes reconciliation for January 2027 cohort. Performance data informs ongoing engagement strategy.

Payer Alignment
January 2028
14 Health Plans Align

The ACCESS Payer Pledge target date. 14 major health plans adopt ACCESS-aligned payment structures across Medicare Advantage, Medicaid, and commercial lines.

Model Matures
2028 – 2036
Multi-Payer Expansion

ACCESS infrastructure extends beyond traditional Medicare. ACO partnerships deepen as claims data, outcome evidence, and multi-payer relationships compound over the 10-year model.

Are you an independent physician or IPA?

Your Medicare patients may be eligible for ACCESS. As a co-managing provider, you refer eligible beneficiaries and earn CMS co-management fees — approximately $100 per patient per year — for reviewing our AI-generated clinical updates. No program management required on your end.

Learn More
Partner With Us

Build Your 2027 ACCESS Partner
Network With Us

We're accepting ACO partnership inquiries now. Spots in our 2027 cohort partner network are limited. Let's explore whether your attributed population is a fit.

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Sentinum Health  ·  Applying for ACCESS Model participation  ·  2027 cohort