Pair Team Joins 150-Participant Medicare AI Pilot as CMS Tests 10-Year Outcome-Based Payments
Updated
Updated · TechCrunch · May 12
Pair Team Joins 150-Participant Medicare AI Pilot as CMS Tests 10-Year Outcome-Based Payments
5 articles · Updated · TechCrunch · May 12
Pair Team said it was accepted into Medicare’s ACCESS program, one of 150 participants in a CMS pilot that starts July 5 and will test AI-driven chronic-care delivery at federal scale.
The 10-year model pays organizations predictable monthly amounts for managing conditions such as diabetes, hypertension, obesity, depression and anxiety, with full payment tied to measurable patient outcomes rather than clinician time.
That structure creates a Medicare reimbursement path for AI tools like Pair Team’s Flora voice agent, which handles intake, check-ins and referrals between visits—work Batlivala says traditional fee-for-service would not cover.
Pair Team, founded in 2019, says its model has cut one in four hospital visits and one in two ER visits for patients in its care; it now employs about 850 clinicians and has access to roughly 500,000 potential patients.
The pilot also carries risks: participants will route sensitive patient data through federal systems with a history of breaches, and CMS innovation programs increased spending by $5.4 billion in their first decade, according to a 2023 CBO analysis.
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CMS ACCESS Model Launch: How Pair Team’s AI-Driven Care Could Transform Chronic Disease Management for 150 Providers by 2026
Overview
The CMS ACCESS Model, launching in July 2026, marks a major shift in U.S. healthcare by moving away from traditional fee-for-service payments that reward quantity over quality. Instead, it introduces outcome-based payments, encouraging providers to use advanced technology to achieve real improvements in patient health and efficiency. Pair Team, chosen as one of 150 participants, is well-positioned for this change with its AI-enabled, team-guided care approach. This new model aims to integrate technology and focus on results, signaling a transformative era for how healthcare is delivered and reimbursed across the nation.