CMS ACCESS Model · July 5 Launch

50% of your ACCESS revenue is withheld. Getting it back depends on whether your patients responded.

Hana calls and texts your patients, collects the measures CMS needs, and sends the data over in the right format. That's how you hit the threshold and get your money back. Five dollars a patient, a month.

What is ACCESS?

ACCESS is a new CMS program that starts July 5. You get paid every month for each patient you enroll. But CMS keeps half of it for up to a year. You earn that half back only if enough of your patients complete their check-ins.

OAPOutcome-Aligned Payment

What CMS pays you per patient each month. Half now, half held back.

OATOutcome Attainment Threshold

The 50% completion rate you have to hit to earn the held-back half.

OAROutcome Attainment Rate

Your real completion rate when CMS settles up. This is the number Hana moves.

The revenue cliff

You go from ~$216 a month to ~$35. And half of that is held back.

Today, a chronic-care patient on remote monitoring brings in about $216 a month. Under ACCESS, your best-paying track pays about $35. Then CMS holds back half of that for up to a year, and only pays it out once your patients respond.

~$216
Remote monitoring / patient / month

What a chronic-care patient brings in today.

~$35
ACCESS CKM / patient / month

The top ACCESS rate. Most tracks pay $15 to $30 a month.

50%
Held back up to 12 months

You only earn it back once your patients complete their check-ins.

Software, not staff

CMS set the rates this low on purpose

At $15 to $35 a patient, you can't pay a person to chase down follow-ups. The math only works if software does it. That's the whole idea behind the program.

Hana is how you get the held-back half. It runs the outreach for you, gets your completion rate over the line, and the money comes back.

When CMS settles up

One number decides how much you get back

It's the share of your patients who finished their check-ins. The higher it is, the more of the held-back money you keep.

OAR ≥ 50%
100%
You get it all back

Half or more of your patients finished their check-ins. CMS pays back the whole held-back amount.

1,000 CKM patients → $210K released
OAR = 40%
80%
You lose a slice

Fall short of 50% and your payout drops to match. At 40%, you get 80% of the held-back money back.

1,000 CKM patients → $168K released
OAR = 20%
50%
As low as it goes

Even in a bad year, you keep at least half of the held-back money. That's the floor.

1,000 CKM patients → $105K released

Getting past 50% is the difference between all your money and a cut of it. Every patient who doesn't finish their check-ins counts against you.

Why voice-first

Most Medicare patients won't use the portal

And if they don't check in, it counts as a miss. So the way you reach them sets a ceiling on your score before you even start. The research is clear on this, and it points to one answer: pick up the phone.

Portal reminders only
45–52%
Below the 50% line

In a Medicare study, sending portal reminders and waiting got just 45 to 52% of patients to respond. That's not enough to clear the threshold.

Add phone calls
75–85%
Clears the line

Add a phone call on top and response jumps to 75 to 85%. Same patients, same portal. The only thing that changed was someone calling them.

Older adults with a portal
~55%
Opened it last month

Even among older adults who have a portal, only about half had logged in that month. Many would rather just talk to someone on the phone.

Those numbers come from studies where people made the calls. Our own 85% is a goal we're working toward, not a promise. We'd rather show you why phone outreach works than throw a number at you.

What Hana does

Built specifically for the ACCESS operational problem

Calls and texts your patients

Hana reaches every patient at the right time, in plain conversation. If someone doesn't answer, it tries again.

Runs the check-ins

Depression, anxiety, and pain questionnaires, plus blood pressure and weight. Asked like a real conversation, not a form to fill out.

Flags what matters

If a patient says something concerning or a number looks off, your team hears about it right away. They see the exceptions, not every call.

Sends CMS the data

Every result goes to CMS in the exact format they want. You don't have to build or manage any of that.

Times it to count

CMS only accepts readings inside tight windows. Hana schedules each call so the data lands when it counts, not a day too early or too late.

Works with your EHR

Connects to Athena, Charm, and most major systems. Hana reads the chart before every call so nothing is asked twice.

The easy one to hand off

Every year, you have to get consent again

For each patient you keep, you have to ask them to re-up every twelve months. Miss the window and you can't bill that patient. It happens again next year, and the year after, for ten years.

You have a 60-day window to get the patient's consent again, confirm they still need the care, and take a fresh reading if the old one's gone stale. Miss it and you can't bill that patient that year. It's easy to forget, and the cost of forgetting is a whole year of payments.

Every year

It comes back every twelve months for every patient you keep. Not a one-off.

Hard deadline

You have 60 days. Inside it you can bill. Outside it you can't.

Real money

Miss it and you lose a full year of payments for that patient.

Nothing clinical

It's consent, contact info, and a quick reading. No doctor needed.

What Hana does

Hana handles the whole thing with one call, on time.

It calls inside the window, gets the consent, confirms the details, takes a fresh reading if needed, and writes it all back to the chart with a timestamp. Your team only sees the few patients who didn't pick up, with time to spare.

Timing matters

A reading on the wrong day doesn't count

CMS only accepts data inside specific windows. A regular reminder app doesn't know that. Hana does, so every call lands when the reading actually counts toward your score.

15

Days to submit a reading

Blood pressure, weight, and check-ins only count if sent within 15 days. Hana calls so the reading is fresh when it goes in.

60

Days to get the first reading

You have 60 days to get a patient's first reading, or they drop out of the program. Hana makes sure it happens in time.

1–2

Years a lab result lasts

Lab results count for one to two years, so they're on a different clock. Hana tracks each one separately instead of nagging everyone at once.

Pricing

We win when you win.

You only pay the success fee when CMS pays you back the money they held for a year. It's the easiest check you'll write.

Base fee

$5
per patient / per month
  • All the calls and texts
  • Every check-in, all tracks
  • Timed to count with CMS
  • Data sent to CMS for you
  • Alerts when something's off

Success fee

+10%
of the held-back money CMS pays you back

You only pay this when CMS pays you back. If the money doesn't come back, neither does our fee.

We both have skin in the game.

The math · CKM track, 1,000 patients

Monthly payment$35/mo × 1,000 = $35,000/mo
Paid over the year$420,000
Held back by CMS (50%)~$210,000
You hit the line → paid back$210,000
Hana success fee$21,000 (10%)
Hana base cost$5 × 1,000 × 12 = $60,000
Total Hana cost$81,000
Revenue protected$210,000
2.6×
Return

Hana brings back $210K for $81K. And if you fall short of the line, say 40%, you'd get just $168K instead, leaving $42K on the table.

ROI Calculator

Run the numbers for your cohort.

Adjust your patient count, track, and response rate. See exactly what's at stake.

500
1005,000

CMS pays $35/patient/mo · Hana base fee $5/patient/mo

55%✓ Over the line
10%← 50% line →90%

You get all of it back

At 55%, you're past the 50% line. CMS pays back the whole held-back amount.

Paid over the year$210,000
Held back by CMS (50%)$105,000
Paid back to you$105,000
Hana base cost$30,000
Hana success fee (10%)$10,500
Total Hana cost$40,500
Revenue-to-cost ratio2.6×
Book a call to walk through your numbers

By track

What Hana handles per track

CKM

Cardiometabolic & kidney health · $35/mo init, $17.50/mo follow-on · OAP $420 initial / $210 follow-on

Required measures

Blood pressure≤130/80, from an approved cuff that sends it in automatically
Weight / BMIvalid within 15 days of submission
HbA1clab, valid 1–2 years
LDL-Clab, valid 1–2 years
eGFR / uACRlab, valid 1–2 years

How Hana handles it

Hana calls and texts patients to keep blood pressure, weight, and lab results current, each one timed so it counts with CMS. One note for honesty: the official blood pressure reading has to come from an approved cuff that sends it in automatically, so Hana flags when a patient needs that set up. Everything goes to CMS in the format they require.

On the roadmap

What we're building next

These aren't live yet, and we won't pretend they are. Here's what's coming, and we're upfront about where it stops.

Coming soon

Care update drafts

Hana writes up the care update for you and gets the patient's okay to share it.

Where it stops

Your system still sends it. We write the draft, we don't move the data.

Coming soon

One call, two tracks

If a patient is in two programs, Hana covers both in a single call so they aren't bothered twice.

Where it stops

It makes the call simpler. It doesn't change what CMS pays.

Coming soon

Heads-up on outside care

If a patient mentions getting care elsewhere, Hana flags it early so your team can reach out.

Where it stops

It's a heads-up, not a fix. Patients are always free to go elsewhere.

None of this is live yet, and none of it changes what CMS pays. If another vendor tells you they can "fix" your numbers here, ask them to show you the rules.

FAQ

Questions we get on every call

July 5 is close

Get set up before
the program starts.

Twenty minutes. We'll show you what the calls sound like for your patients and walk through your numbers.

Book a 20-min call

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ACCESS Pricing & ROI Calculator

The numbers for each track, with your patient count filled in.