Federal agencies push AI in healthcare with new chronic care model
The U.S. government is expanding its use of artificial intelligence in clinical settings, launching a ten-year program to test how tech can manage chronic diseases and control costs.
Federal healthcare officials are accelerating the integration of artificial intelligence into clinical care, identifying it as a central strategic priority for the Centers for Medicare & Medicaid Services. At a recent industry gathering in Washington, D.C., agency leaders outlined a plan to establish clearer rules for how AI tools are approved, regulated, and paid for within the healthcare system.
The strategy centers on a new ten-year initiative called ACCESS, which aims to use technology to manage chronic conditions like diabetes and hypertension. While the agency projects that this approach could significantly lower overall medical costs by 2028, clinicians and industry observers note that the shift introduces new complexities in determining when AI provides genuine medical value versus offering general wellness features.
New strategy focuses on trust and regulation
According to reporting from GN technics/ai (en-US), the CMS strategy rests on four main pillars: building public trust, improving data sharing, creating clear market access paths, and developing payment frameworks. Stephanie Carlton, who serves as both deputy administrator and chief clinical AI officer, emphasized that the agency is moving beyond simple decision support into higher-risk clinical functions. This transition requires careful evaluation through state-level pilot programs to ensure safety and efficacy before widespread adoption.
ACCESS model targets chronic disease management
The ACCESS program, which stands for Advancing Chronic Care with Effective, Scalable Solutions, has already accepted more than 150 healthcare organizations for its initial launch. The model provides predictable, recurring payments based on outcomes for treating conditions such as obesity, depression, and chronic kidney disease. By linking reimbursement to measurable health improvements rather than just the volume of services, the agency hopes to drive efficiency and quality simultaneously.
This approach represents a significant shift in how Medicare pays for care. Traditionally, payments go to clinicians and facilities. Under ACCESS, technology companies can act as direct partners and providers, receiving compensation for the health outcomes their tools generate. Officials describe this as a paradigm shift that tests whether software and AI can deliver medical value comparable to human care.
Reimbursement challenges and cost reduction hopes
A critical question remains regarding how to distinguish between general wellness apps and tools that perform necessary medical functions. Carlton noted that the agency is working to define when it is reasonable and necessary to pay for AI-enabled technologies. The goal is to avoid subsidizing generic features that are already available cheaply elsewhere, while still supporting innovations that genuinely improve patient outcomes.
The agency aims to demonstrate by late 2028 that technology can have a deflationary impact on healthcare costs. By engaging tech companies as partners in the Medicare system, CMS is testing a new model of care delivery. However, the success of this ambitious vision depends on balancing rapid innovation with rigorous oversight to protect patient safety and ensure financial sustainability.
