Assessing eligibility of Medicare beneficiaries with chronic conditions for the ACCESS model.

INTRODUCTION

The Advancing Chronic Care with Effective Scalable Solutions (ACCESS) model is a new outcome-aligned payment model intended to support technology-enabled chronic disease management among Traditional Medicare (TM) beneficiaries. However, the national population potentially eligible for ACCESS remains poorly characterized, particularly those with multiple chronic conditions.

METHODS

Using nationally representative survey data from the 2023 Medical Expenditure Panel Survey, we described the health characteristics and health care utilization patterns of TM beneficiaries potentially eligible for the ACCESS model.

RESULTS

A total of 56.3% of beneficiaries (estimated 9.1 million) were potentially eligible to participate in the model, 24% of beneficiaries (estimated 2.2 million) had multiple chronic conditions, and beneficiary telehealth use for cardio-kidney-metabolic and musculoskeletal conditions was limited.

CONCLUSION

The sizable proportion of TM beneficiaries potentially eligible for more than one ACCESS track suggests a deliberate approach to care coordination to support technology-enabled chronic disease management in older adults.