Insight
A Guide To Electronic Health Record (EHR) Integration
EHR integration connects electronic health record systems with other software to enable comprehensive insights at the point of care. Learn more in this guide.
The Capabilities Required to Succeed Under ACCESS
A readiness guide for outcome-based chronic care
The CMS ACCESS Model represents a fundamental shift in how chronic care is paid for, moving from activity-based reimbursement to outcomes measured across entire patient populations.
That shift raises the bar. Success under ACCESS requires more than care management programs or reporting workflows. Organizations must demonstrate sustained improvement backed by accurate, timely, and usable data.
This guide outlines five core capabilities organizations need in place to deliver outcomes at scale—and prove it.
The 5 Core Capabilities for ACCESS Success
1. Trusted, Normalized Data
What it is: Accurate, complete, and consistent clinical data across sources.
Why it matters: Outcome performance is assessed across full patient panels—not samples.
Readiness signal: Teams trust reported measures without manual reconciliation.
2. Standards-Based Interoperability at Scale
What it is: FHIR-based exchange that supports reporting and care coordination without custom builds.
Why it matters: ACCESS requires ongoing data submission and proactive information sharing.
Readiness signal: New integrations do not require one-off engineering work.
3. Role-Specific Access and Usability
What it is: Data delivered in forms patients, providers, and care teams can use.
Why it matters: Access alone does not drive outcomes—action does.
Readiness signal: Users can interpret and act on data without added training.
4. Data Governance and Accountability
What it is: Clear ownership for data quality, submission, and issue resolution.
Why it matters: Governance gaps quickly become operational and financial risks under outcome-based payment.
Readiness signal: A named owner is accountable for data end to end.
5. Operational Readiness to Act on Insights
What it is: The ability to translate data into timely clinical and operational action.
Why it matters: ACCESS rewards sustained improvement, not early wins.
Readiness signal: Data reliably triggers defined interventions or escalations.
Insight only matters if it drives action.
See the capabilities organizations need to move from analysis to execution under ACCESS.
Based on Policy Insights
This guide is based on insights shared during Arcadia’s Policy Pulse webinar on the CMS ACCESS Model, which explores model requirements, timelines, and readiness considerations.
