12 Days of ACCESS: The Medicare Beneficiary Journey
Technical deep-dive on patient flow, data requirements, and care coordination obligations
This is Part 3 of a 12-part Techy Surgeon operator series on the CMS ACCESS Model. To navigate this series start to finish, check the archives if you’re a subscriber or check out this page on Techy Policy.
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In Part 2, we mapped the patient journey through ACCESS—from initial discovery to care period completion. This operates as a defined state machine with specific API touchpoints, timing requirements, and mandatory data submissions. Here’s the technical walkthrough.
Stage 1: Discovery and Directory
Patients find ACCESS participants through three primary pathways: the CMS-hosted public directory, direct referral from their primary care practitioner, or outreach from ACCESS participants following standard CMS marketing rules.1
The CMS directory will display: participating organization names, clinical tracks offered, conditions treated within each track, and risk-adjusted clinical outcomes based on submitted OAP measure data.2 This transparency is designed to drive quality-based competition—high performers get visibility, patients and referring clinicians can make informed choices.
No warm handoff is required. Patients can self-enroll directly with any ACCESS participant they choose.3 Medicare beneficiaries retain complete freedom of choice—ACCESS enrollment doesn’t restrict access to any covered Medicare services or providers.
