ACCESS and the Future of Chronic Care: CMSA Helps Define the Role of Case Management
When the Centers for Medicare & Medicaid Services (CMS) introduces a new care delivery model, healthcare organizations begin asking how they’ll implement it. CMSA asked a different question: Where does professional case management fit? That question inspired the development of CMSA’s new position paper, Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model: The Role of Case Management.
This year, CMS launched the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model, a 10-year initiative designed to improve care for Medicare beneficiaries living with chronic conditions. The model emphasizes technology-supported care, interdisciplinary collaboration, health equity, and outcomes rather than volume, principles that have long been at the heart of professional case management.
Developed by CMSA Fellows and subject matter experts, the position paper demonstrates why professional case managers are essential to achieving the goals of the ACCESS Model. It provides healthcare organizations with a roadmap for integrating case management into technology-enabled, value-based care while highlighting the profession’s contributions to care coordination, patient engagement, health equity, and improved outcomes.
While technology such as remote monitoring, telehealth, predictive analytics, and digital therapeutics will play an increasingly important role in chronic disease management, technology alone cannot improve outcomes. Success depends on skilled professionals who can coordinate care, engage patients, address barriers, and connect the many pieces of an increasingly complex healthcare system.
For decades, professional case managers have served as the link between patients, providers, and community resources, helping people navigate increasingly complex healthcare systems. The position paper illustrates how case management supports every stage of the ACCESS Model, from care coordination and transitions of care to behavioral health integration, patient engagement, addressing social drivers of health, and helping patients successfully adopt technology-enabled care. It also explores the workforce competencies, organizational considerations, and policy recommendations needed to fully realize the promise of the model.
Perhaps most importantly, the paper positions CMSA as a leader in the national conversation surrounding healthcare transformation. New payment and care delivery models inevitably reshape how healthcare teams work together. By publishing this paper early in the implementation of ACCESS, CMSA is helping ensure that professional case management is recognized not as an ancillary service, but as a foundational component of coordinated, value-based care.
This resource is intended for more than just case managers. Healthcare executives, physician leaders, policymakers, participating organizations, and interdisciplinary care teams can all benefit from a deeper understanding of the unique value case managers bring to technology-enabled, patient-centered care.
As organizations across the country begin implementing the ACCESS Model, CMSA hopes this position paper serves as both a practical resource and an advocacy tool, helping healthcare leaders better understand the essential role professional case managers play in achieving better outcomes, advancing health equity, and delivering coordinated, technology-enabled care.
Download the ACCESS Model Position Paper: The Role of Case Management at cmsa.org.
