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Blue Shield of California expects to introduce chronic-care models resembling Medicare’s ACCESS experiment in its commercial plans in 2027. The insurer has not finalized the design: as of an October 1, 2026 report by STAT, it was still deciding whether to use CMS payment amounts and which care organizations to involve. That means the planned program should not be treated as a confirmed copy of Medicare’s model.
What Blue Shield says it may do
Blue Shield of California, which STAT reported serves 6 million members, expects to offer models similar to ACCESS in commercial plans in 2027. The insurer’s chief medical officer, Ravi Kavasery, told STAT that payment amounts and participating organizations were still being worked out.
The sources do not establish Blue Shield’s final eligibility rules, initial conditions, outcome measures, reporting requirements, enrollment process, or detailed launch date. In particular, it is not known whether the commercial program will use the payment amounts CMS set for ACCESS. The 2027 date is an expected launch, not confirmation that a finalized benefit is available to members.
How Medicare’s ACCESS experiment works
ACCESS stands for Advancing Chronic Care with Effective, Scalable Solutions. CMS describes it as a voluntary, 10-year Original Medicare model testing recurring Outcome-Aligned Payments for technology-supported care. It began July 5, 2026, and is scheduled to run through June 30, 2036. CMS will evaluate quality and Medicare spending; improved outcomes or lower spending have not been established as results.
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The payment design is intended to address a mismatch in traditional Original Medicare fee-for-service, which generally pays for defined activities and devices rather than the broader work of technology-supported chronic care. Under ACCESS, a participating organization receives recurring payments to manage a qualifying condition. Full payment is tied to measurable outcomes, assessed against the patient’s starting point. CMS gives reducing blood pressure by 15 mmHg as an example of a target—not a universal requirement for every patient or condition.
CMS’s description of the model is available at the ACCESS model page; its operational details are addressed in the ACCESS Technical Frequently Asked Questions.
What care can include
Care is not limited to an app or device. Depending on the patient and condition, it may combine clinician consultations, nutrition or exercise support, behavioral support, counseling, education, care coordination, medication management, diagnostic testing, and FDA-authorized devices or software. Delivery may be in person, virtual, asynchronous, or through other clinically appropriate technology-enabled methods.
Organizations participating in Medicare ACCESS must be enrolled Medicare Part B providers or suppliers, meet state licensure and applicable HIPAA and FDA requirements, and designate a physician clinical or medical director. CMS says it will monitor performance and publish risk-adjusted outcomes.
How it fits with regular Medicare care
ACCESS is designed to complement, not replace, beneficiaries’ usual care. Participating organizations share care plans and updates with primary-care and referring clinicians. Those clinicians may bill a co-management payment for reviewing updates and documenting coordination. Beneficiary participation is voluntary: people keep their regular Medicare services and may continue seeing any Medicare provider.
Which conditions Medicare ACCESS covers
The initial model has four tracks. CMS says additional tracks are scheduled to begin April 1, 2027.
| Track | Conditions |
|---|---|
| Early cardio-kidney-metabolic (eCKM) | Hypertension; dyslipidemia; obesity or overweight with a central-obesity marker; prediabetes |
| Cardio-kidney-metabolic (CKM) | Diabetes; chronic kidney disease stages 3a or 3b; atherosclerotic cardiovascular disease, including heart disease |
| Musculoskeletal (MSK) | Chronic musculoskeletal pain |
| Behavioral health (BH) | Depression and anxiety |
| Tracks scheduled for April 1, 2027 | Heart failure; COPD; substance use disorder; tobacco cessation; a follow-on chronic musculoskeletal pain track |
CMS says current participants and applicants will not need to reapply for the new tracks. The conditions listed here describe Medicare ACCESS; they do not establish which conditions Blue Shield’s commercial version will cover.
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Medicare ACCESS and a possible Blue Shield program are not the same benefit
ACCESS itself applies to qualifying people with Original Medicare. Medicare Advantage enrollees are not included in the CMS model. A private insurer may independently offer a similar program to its own members, but that does not make the program part of ACCESS or extend Medicare’s rules and benefits to them.
| Question | Medicare ACCESS | Blue Shield commercial plans |
|---|---|---|
| Who is covered? | Qualifying people with Original Medicare | Exact eligibility rules not stated; Blue Shield expects a 2027 commercial-plan launch, according to STAT’s October 1, 2026 report |
| Which conditions? | Four initial tracks, with additional tracks scheduled for April 1, 2027 | Not stated by Blue Shield in the cited STAT report |
| Payment design? | CMS Outcome-Aligned Payments, with full payment tied to measurable outcomes | Not settled; Kavasery told STAT that whether Blue Shield will use CMS payment amounts was still being decided |
| Care organizations? | Medicare Part B-enrolled providers or suppliers meeting CMS requirements | Not settled; Blue Shield had not identified which organizations it would work with, according to STAT |
| Enrollment and launch details? | Beneficiary participation is voluntary; model began July 5, 2026 | Specific enrollment rules and a detailed start date beyond the expected 2027 launch are not stated |
What the ACCESS Payer Pledge means
Blue Shield is also among the signatories to CMS’s ACCESS Payer Pledge. CMS’s February 12, 2026 announcement, updated September 15, 2026, says signatories representing more than 165 million people across Medicare Advantage, Medicaid, and private coverage pledged to offer payment arrangements aligned with ACCESS’s core principles by January 1, 2028. The pledge is broader than Blue Shield and includes national and regional health plans.
A pledge to offer aligned arrangements is not evidence that every signatory has already launched a program, adopted CMS’s exact rates, or made an identical benefit available to all members. CMS has listed organizations including Arkansas Blue Cross and Blue Shield, Blue Shield of California, Blue Cross and Blue Shield of Minnesota, Blue Cross Blue Shield of North Dakota, BlueCross BlueShield of Tennessee, CareFirst, Centene, Cigna, CVS Health, Devoted Health, Guidewell, Horizon Blue Cross Blue Shield of New Jersey, Humana, and UnitedHealthcare. CMS later added Baylor Scott & White Health Plan, TriWest Healthcare Alliance, and BCBS Rhode Island. Its announcement is at CMS’s ACCESS Payer Pledge page.
What to watch for before calling it a rollout
For Blue Shield members, the practical details that determine whether this is a usable benefit remain unsettled. A finalized announcement would need to explain:
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- Which commercial plans and members qualify, and how participation works.
- Which conditions and care services the program will cover.
- Which organizations will provide care and how they will coordinate with a member’s existing clinicians.
- How outcomes will be measured, reported, and used to determine payment.
- Whether Blue Shield adopts CMS payment amounts or builds a separate commercial payment arrangement.
- The actual start date and how members can find out whether the program applies to them.
CMS’s participant directory reports more than 160 participating health care organizations and may be updated; that figure describes the Medicare model, not Blue Shield’s future commercial network. See the CMS ACCESS participants page.
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