Medicare has introduced ACCESS (Advancing Chronic Care with Effective, Scalable Solutions), a 10-year pilot program designed to test AI-driven healthcare at a federal level.

Unlike traditional Medicare, which reimburses based on time spent with clinicians, ACCESS rewards health outcomes for chronic conditions such as diabetes, hypertension, chronic kidney disease, obesity, depression, and anxiety.

Participants, including startups like Pair Team, receive predictable payments and only earn full reimbursement when measurable health goals are achieved.

Pair Team, which has focused on patients with chronic conditions who also face social challenges like unstable housing and food insecurity, uses a voice AI agent called Flora to handle intake, coordinate referrals, and maintain engagement between visits.Flora provides companionship and regular monitoring, which has been shown to significantly reduce avoidable emergency and hospital visits.

ACCESS was designed by former startup founders within the CMS Innovation Center to encourage competition and AI integration in healthcare, though risks include sensitive patient data exposure and financial uncertainties for organizations that are not AI-driven.

Overall, the program represents a major shift toward outcome-based, AI-supported healthcare, signaling potential scalability and efficiency improvements for traditionally underserved populations.