CMS 2025 Year-End Announcements
The Centers for Medicare and Medicaid Services (CMS) provided new information for key health care funding vehicles. First, all 50 states have been awarded funds through the Rural Health Transformation Program, a $10B, five-year initiative originally intended to offset some of the financial consequences in the 2025 Budget Act. The first year grants range from $147M (New Jersey) to $281M (Texas), with all states receiving half of the funds, and the other half awarded based on the initiatives noted in their applications. There is no requirement for states to distribute any funds to local providers, and future awards may be reduced if there is insufficient progress on a state's planned initiative.
CMS also released the Request for Applications (RFA) for the 10-year, voluntary Medicare alternative payment model, ACCESS (Advancing Chronic Care with Effective, Scalable Solutions). Participants must be Medicare Part-B enrolled organizations, and must incorporate "innovative technology-supported care that improves patients' health and complements traditional care", and beneficiaries will need to voluntarily align themselves to a particular ACCESS organization. Organizations may choose across four clinical tracks: early cardio-kidney-metabolic (eCKM); cardio-kidney-metabolic (CKM); musculoskeletal (MSK); and behavioral health (BH). The CKM track will care for patients with at least one of: diabetes mellitus, chronic kidney disease, or atherosclerotic cardiovascular disease (ASCVD). CAPC anticipates that this track may offer partnership opportunities for palliative care programs and specialists, who may be able to bill for co-management of these beneficiaries, up to $100 per beneficiary annually. The model is expected to provide reliable payments for health technology vendors, providing support for a variety of services including, lifestyle modification, medication management, and remote monitoring. Applications are due April 1, 2026 and the first performance period is expected to begin July 5, 2026.