How Native Practitioners Can Use the CMS ACCESS Model to Strengthen Chronic Care in Indian Country

Chronic disease affects Our Relatives at staggering rates, and now a federal payment model finally opens the door for Native health systems to get paid for outcomes.

The ACCESS Model Creates a New Payment Path for Indigenous Health Innovation

The Centers for Medicare & Medicaid Services launched the ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model, a 10-year national program beginning July 5, 2026, that pays Medicare-enrolled care organizations for managing chronic conditions like diabetes, hypertension, chronic kidney disease, depression, and musculoskeletal pain. Indian Health Service facilities, tribally run hospitals, and Native practitioners serving elders and Native populations through culturally competent care are invited to participate. Organizations must enroll in Medicare Part B, designate a physician Clinical Director, and apply through the CMS Participant Portal by April 1, 2026, to join the first cohort.

Outcome-Aligned Payments Reward Holistic Indigenous Care Approaches

ACCESS replaces traditional fee-for-service billing with Outcome-Aligned Payments tied to measurable health improvements, such as lowering blood pressure by 10 mmHg or reducing HbA1c levels. This structure could support the holistic, culture awareness care models that Native-owned health organizations already practice, including lifestyle coaching, behavioral support, telehealth, and wearable health monitoring. As Manatt Health analysis confirms, rural patients qualify for a fixed payment adjustment, directly benefiting tribal communities and remote service areas!

Technology-Supported Care Reaches Elders and Rural Native Communities

The ACCESS Model’s four clinical tracks, early cardio-kidney-metabolic, cardio-kidney-metabolic, musculoskeletal, and behavioral health, address conditions that disproportionately impact Native populations. Fierce Healthcare reports that two-thirds of Medicare beneficiaries live with these chronic conditions, and technology-supported care through telehealth, remote monitoring devices, and digital coaching apps could bridge geographic barriers that have long limited care access for Our Relatives.

Ellsworth Supports Native Health Organizations Ready to Apply

Ellsworth, a Native-owned, ISBEE-certified medical staffing company, stands ready to connect tribal health programs and IHS facilities with culturally competent practitioners who understand the benefits of the ACCESS Model. If your organization serves Indian Country, now is the time to prepare your Medicare Part B enrollment, build your clinical team, and apply. Contact Ellsworth today to staff the Native practitioners who will lead this transformation.