Medicare's New Payment Model Opens Door for AI-Driven Healthcare at Federal Scale

Summary

Medicare's Centers for Medicare & Medicaid Services (CMS) has launched ACCESS (Advancing Chronic Care with Effective, Scalable Solutions), a 10-year pilot program that fundamentally reimagines how healthcare can be paid for and delivered using AI. Pair Team, a healthcare startup that has built an AI-powered patient engagement platform, was selected as one of just 150 organizations chosen to participate in the program, which launches July 5.

Unlike traditional Medicare reimbursement models that compensate based on time spent with clinicians, ACCESS creates a new payment mechanism that rewards health outcomes rather than activities. This structure enables AI agents like Pair Team's voice assistant Flora to be reimbursed for patient monitoring between clinical visits, coordinating care referrals, and ensuring medication adherence. The program covers six chronic conditions: diabetes, hypertension, chronic kidney disease, obesity, depression, and anxiety.

Pair Team's acceptance into ACCESS represents a validation of its seven-year approach to addressing healthcare's social determinants. The company employs roughly 850 clinical professionals and was built on the premise that improving patient health requires addressing the full context of someone's life—including housing, food security, and transportation. By deploying Flora as its primary patient-facing interface nine months ago, Pair Team has demonstrated that AI can scale healthcare delivery while maintaining the human oversight necessary for complex patient populations.

• This regulatory shift could unlock rapid scaling of AI-driven healthcare for vulnerable populations dealing with housing insecurity, food insecurity, and chronic disease