In the spring of 2027, five new pathologies will join the system that remunerates technology providers on the results obtained in patients, and not on the volume of procedures.
Medicare's ACCESS program, launched last year to fund chronic disease monitoring tools, is expanding. In addition to the five existing components — diabetes, high blood pressure, chronic musculoskeletal pain, depression and anxiety — will be added in the spring of 2027 to include substance use disorders, heart failure, chronic obstructive pulmonary disease, tobacco use and extensive musculoskeletal management.
The base is broad: about 75% of Medicare beneficiaries meet the criteria for at least one of the proposed pathways. Thirty-nine companies are now listed in the directory of approved providers.
The economic model is the real singularity of the system. Remuneration is indexed to results: a provider receives more when the patient's condition actually improves. Medicare is thus trying to shift the reimbursement of health technologies from the volume of services provided to their measured clinical effectiveness.
Read the full article on the original source
Go to the source →