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More ACCESS, Sword Gets Headspace, and AI Scribe Blindspots
By Jason Barry and Virginia Hunt
September 17, 2026
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Together with
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“Customization was where margins went to die.”
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Elion Director of Research Colin Durant
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Patients managing chronic conditions got 99 problems and ACCESS ain’t one. You have to love the mixed signals coming out of Medicare’s front office.
– Jason Barry, Managing Editor
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Medicare’s experiment in paying tech companies to manage chronic conditions has barely gotten underway, and CMS is already making it bigger.
Advancing Chronic Care with Effective, Scalable Solutions. ACCESS launched in July to get more companies to lean in on Medicare by rewarding them for using technology to manage diabetes, hypertension, chronic musculoskeletal pain, depression, and anxiety.
- The model’s core mechanism for accomplishing that is Outcome-Aligned Payments (OAPs), which pays providers more if their patients’ conditions improve.
- The catch is that these OAPs were “set low” in an effort to encourage innovation that reduces reliance on clinicians, with maximum yearly OAPs ranging from $180 per patient for behavioral health to $420 for cardio-kidney-metabolic conditions.
New tracks are now set to kick off spring 2027. CMS announced that it’s expanding the number of conditions eligible for ACCESS to include substance use disorder, heart failure, COPD, tobacco use, and longer-term support for MSK conditions (a big question mark when the initial model debuted).
- Put it all together, and about 3 in 4 Medicare beneficiaries will reportedly be eligible for at least one of the tracks.
Who’s participating? Medicare was kind enough to publish the answer in a shiny new directory of providers who can take patients under ACCESS – 39 in total – only a small slice of the 150 companies that were provisionally accepted earlier this year.
- In: Whoop, Withings, Welldoc, Cadence, and a lengthy roster of smaller players.
- Out: Omada, Sword, and Hinge, all powerhouses in the chronic condition management space that said the OAP caps wouldn’t support their clinician-heavy models.
Commercial payers are also on board. Although ACCESS is Medicare-only, CMS’s chief AI and technology officer said 17 major health plans covering 165M lives have committed to adopt ACCESS-aligned approaches by 2028, including UnitedHealthcare, Humana, Cigna, and Centene. That’s some real scale if they follow through.
The devil’s in the details. Critics worry ACCESS vendors will fragment care if they don’t loop in primary care, so the model requires PCP outreach and offers small coordination payments.
- The expansion also landed one day after comments closed on the 2027 MPFS, which proposes cutting RPM reimbursement because vendor-delivered services fragment care – the exact same thing that ACCESS invites.
The Takeaway
CMS is sticking to its agenda. It wants to pay less for chronic care, and it wants to pay it to whoever can deliver outcomes without a clinician on every call. Whether $420 a year actually gets you better outcomes is now a live experiment with 39 participants.
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Telehealth Has a Ceiling. Here’s How MetroHealth Broke It
For too many patients, traditional telehealth visits often lead to a dead end. To reach its full potential, virtual care needs a reboot. The MetroHealth System partnered with Ovatient to do just that with a new virtual-first care model built on the EHR and connected to patients’ ongoing care journeys. A study of 50k patient encounters shows the results: 100% of patients were able to have a new appointment within 3 days, 35% of virtual primary care patients were net new or re-engaged, and virtual urgent care achieved 17% lower 72-hour ED use than in-person visits. Read the report to learn more about MetroHealth’s approach.
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A New Path for ACCESS Model Participants
Building your CMS ACCESS program? Withings was accepted into the inaugural cohort as both a participant and a device partner via the ACCESS Tools Directory. Bring the same FDA-cleared, cellular-enabled devices into your program, including BPM Pro 2, capturing clinical measurements and patient-reported outcomes at the point of reading, purpose-built for value-based cardio-kidney-metabolic care.
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- Sword Gets Headspace: The rumors proved true yet again after Sword grabbed the OG meditation app Headspace for nearly $300M. Sword has quickly grown beyond its MSK roots with the launch of its AI Care Platform, which provides AI-driven insights to enable proactive and personalized care not just for muscle pain, but also for women’s health, cardiometabolic health, and now mental health. Headspace is trusted by over 100M people across 200 countries, and a lot of what actually works in mental healthcare (structured CBT, behavioral activation, relapse prevention) is “exactly the kind of thing” you can hand to an AI system like Sword’s to deliver ongoing support for both patients and clinicians.
- Abridge Debuts Pre-Bill Review: Abridge just threw down the other RCM gauntlet with the latest extension of its clinician intelligence platform: a pre-bill review capability built specifically for CDI, coding, and revenue cycle teams. The launch bridges the gap between care that’s delivered and care that’s documented, comparing final coded diagnoses and DRGs against what the documentation supports, while surfacing the evidence behind every discrepancy – before the claim leaves the team’s hands. The announcement leans in on the advantages that are out-of-reach for point solutions, like running on the same platform and clinical record already in place at the point of care.
- AI Scribe Blindspot: A review of 27 studies in BMJ Digital Health revealed that ambient scribes have some glaring blindspots outside of their role as a productivity tool. While a growing body of evidence validates the benefits of scribes on administrative work, the review found that patient narratives and experiences are almost entirely absent, a byproduct of AI scribes stripping the social cues and “chit-chat” that happens throughout consultations. It was also interesting to see how scribes are slowly changing the dynamics of consultations, with more clinicians verbalising observations and plans that were previously documented privately.
- AliveCor Debuts KardiaACCESS: AliveCor took the lid off KardiaACCESS to serve as the bridge between care teams and patients managing their blood pressure, diabetes, and heart health – both in and out of the office. As the name would suggest, the new CMS ACCESS model allows KardiaACCESS to support eligible Medicare beneficiaries with clinician-guided care and connected health tools at $0 out-of-pocket cost. Rather than treating symptoms in isolation, KardiaACCESS treats the Cardio-Kidney-Metabolic system as a whole, addressing the links between BP, lipids, and kidney function to keep patients out of the hospital. Now live in 48 states.
- State of Practice Management: Third Way Health’s State of Practice Management 2026 mapped out how medical practices are addressing staffing, AI, and patient access in the front office. A majority (80%) of execs now cite patient experience as the top barrier to AI adoption, yet improved patient experience is also the top reported outcome (79%) among those who’ve already deployed it. The other main takeaway was that the return on AI investment isn’t the primary problem. Only 11% of practices cite “cost relative to results” as one of their biggest challenges, far behind the ongoing need for human backup (59%), vendor support and management (38%), and staff adoption (32%).
- Unapproved AI Use: Bad news for data security – about three-quarters of health systems implement AI tools without formal approval. That’s from an Imprivata survey of 250 U.S. healthcare leaders, 60% of which ranked security as their biggest worry despite the vast majority saying that their org has visibility into AI agent activity (86%). Considering that 72% reported AI agents are deployed without formal IT approval at least occasionally, the findings suggest that some orgs may be more confident in their ability to safely use AI agents than their current environments warrant.
- Zocdoc’s New Chapter: After nearly two decades helping patients find care via its doctor discovery and booking marketplace, Zocdoc is opening up its infrastructure to power access to care everywhere patients search. The new Care Access Network enables partners to integrate Zocdoc’s real-time booking capabilities for their users on their properties. ZocDoc believes at 200k providers it’s reached the tipping point to go from its own marketplace to a platform that provides access for the whole industry, and some big name launch partners seem to agree, including Amazon Health AI, Gemini, and Yelp.
- Headway in Hospital Transparency: It’s been nearly six years since hospital price transparency rules went into effect, and CMS has finally made (some) progress on enforcement. A PatientRightsAdvocate.org analysis showed compliance has more than doubled since January 2024. The bad news is that only 49% of hospitals arenow conforming to the rules, but CMS is tightening the reins. The agency doled out over 500 warnings in June and has fined a total of 28 organizations for noncompliance, up 13 from January 2024.
- Nara Health Nabs $10M: Nara Health brought in $10M of seed funding to help more companies tailor health plans for their employees. The AI-enabled third-party administrator offers alternative plan designs like direct provider contracts, reference-based pricing, and direct primary care, which can reportedly reduce employer healthcare spending by over 15% while giving employees easier access. Nara’s platform has more than 25k members, and it answers their calls within five seconds and provides same-day prior authorizations (compared to usual three-to-five-day waits).
- Younger Members Mistrust Payers: As younger generations increasingly make up more of the commercial market, payers may need to put in better PR – a good word with ChatGPT – to gain their confidence. An Accenture survey of 1.2k customers found just 46% of Gen Z and Millennials trust payers, leading 62% of them to ask AI for help when choosing a health plan. What are they looking for from their health plans? More support in making good health decisions and better navigation to top-notch care.
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The Distance Between an Idea and Reality
Almost every good idea in healthcare already exists. The hard part is building it. Bunkerhill Health CEO Nishith Khandwala believes shortening the distance between ideas and solutions will be the defining feature of healthcare’s next chapter, and his new essay lays out how agentic AI is making it happen – not by being the hero, but by giving heroes the tools they need.
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State of Payor Enrollment and Credentialing
AI is changing the way that healthcare leaders tackle provider network management. Medallion’s latest report breaks down the biggest challenges, emerging trends, and how automation is transforming the landscape. Get the insights you need – read the full report today.
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Evidence, in the Flow of Care
Heidi brings trusted guidelines and peer-reviewed research directly into clinical workflows so decisions don’t stall care. Clinicians get clear, evidence-based answers without leaving the conversation. No ads, no limits, and no outside interests getting in the way of care. Find out how with Heidi Evidence.
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- Making the Case for AI: Healthcare organizations have a lot to gain from implementing AI that can enhance coding accuracy and quality metrics, but securing buy-in from leadership is a crucial first step. Check out Navina’s new guide by Dr. Michael S. Barr to see exactly how to demonstrate clear financial benefits, ROI potential, and alignment with organizational priorities to help ensure AI projects are successful.
- The Right Trial, the Right Patient, the Right Moment: For too long, the distance between a patient and a potentially life-changing clinical trial has come down to chance. Abridge is changing that, surfacing relevant trials directly in the encounter, grounded in the patient’s own story, at the moment it matters most – all in partnership with Eli Lilly. Discover how Abridge’s AI-native clinical intelligence platform is enabling patient-centered trial recruitment today.
- Turning Ideas Into Action: Healthcare has never been short on great ideas. What is new is the ability to turn them into reality at the pace patients need. Discover how Bunkerhill Health is closing the distance between knowing and doing, so providers can get back the two things they never have enough of: the time and the clarity to care for people.
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