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A tech-focused government pilot could make 2026 a breakout year for digital health firms, investors and entrepreneurs tell Axios Pro.

The big picture: The ACCESS program shines a novel spotlight on health tech companies, which have historically faced reimbursement and regulatory obstacles.

Catch up quick: Introduced this month, ACCESS pays participating Medicare providers and suppliers a (yet-to-be determined) fixed amount to manage chronic issues.

Zoom in: ACCESS allows digital health vendors to be paid directly for certain chronic care conditions — they don't need a clinician to bill.

Payments are based on outcomes — such as lower costs or improved patient health — rather than the quantity of services provided.

What they're saying: "Is it simple enough? Check. Is it aligned with outcomes? Check," says Omada Health CEO Sean Duffy.

"I'm encouraged to see CMS moving toward outcomes-based payment models," says Meru Health CEO Kristian Ranta. "You wouldn't pay your barber just for waving the scissors; you pay for the haircut."

Context: Medicare has historically adopted technologies and models that other programs eventually follow, making it a logical place for the program to start.

Medicare is "the R&D engine for health care payments," says Venrock partner Bob Kocher.

Between the lines: ACCESS includes a co-management model that encourages primary care physicians (PCPs) to participate.

"Is it going to fragment care away from primary care providers?" Duffy recalls initially asking of the program. "The answer is no — they've created a world where PCPs can be part of this."

What we're watching: The government programs could "strengthen continuity of care by supporting patients during the critical period between office visits," says S.V. Mahadevan, chief medical officer of Fold Health.

Fold is a primary care enabler whose investors include Iron Pillar and Jonathan Bush.

This is "going to be a net positive for the industry in the long run," says Joe Connolly, CEO of VC-backed women's virtual health clinic Visana.

The bottom line: The government efforts "support a meaningful shift toward technology-enabled, value-based chronic care," Mahadevan says.

The government still hasn't ironed out key details of its new health tech programs, to the chagrin of investors and entrepreneurs.

Why it matters: The programs could be a massive health tech enabler — as long as vendors and clinicians can effectively coordinate care and be paid for it.

"My simple thought is: There's a lot we don't know. What's going to be paid? Where's attribution going to be?" says LRVHealth partner Keith Figlioli.

Friction point: Unanswered questions include the types of activities that qualify for payment, the frequency of government evaluation, and the consequences of unachieved outcomes in the programs.

"What constitutes engagement and a billable event — does reading a text count? Opening a text or email?" notes Venrock's Kocher.

"How they will claw back money if an outcome is not achieved? How often you need to show outcomes?" Kocher adds.

Zoom in: Some CEOs are concerned that the sheer number of digital health vendors involved in ACCESS could overwhelm participating PCPs.

"Imagine [you were a PCP] receiving updates from 10+ different vendors, all managing your patients," says Visana Health's Connolly. (Investors in Visana, a women's virtual health company, include Cigna Ventures and Intermountain Ventures.)

"Clinicians cannot — and will not — tolerate another round of policy whack-a-mole games disguised as transformation," says Offcall co-founder Graham Walker.

Inside the room: Existing digital health obstacles also persist, such as high consumer acquisition costs, churn, and challenges generating revenue.

"It is really hard to collect patient-reported outcome data on an ongoing basis," adds Connolly.

Then there's the issue of fraud, which could prove more difficult without the traditional route of pursuing deceptive physicians and provider groups.

What's next: Streamlined care coordination will be critical to the model's success, several investors and CEOs say.

"PCPs are not the direct target of ACCESS, but they'll be critical to its success," says Figlioli.

The bottom line: "The devil is in the details," Figlioli, Kocher, and Connolly all tell Axios.

Digital health companies are already courting ACCESS

Startups cheer new Medicare payment model

New Medicare trial may boost digital care

Town Hall Ventures' Andy Slavitt on a "bold" health tech initiative at CMS

Digital health sector sees hope in ACCESS for 2026

Investors and CEOs see ACCESS as a major digital health enabler.

Illustration of a caduceus with a siren on top of it.

A tech-focused government pilot could make 2026 a breakout year for digital health firms, investors and entrepreneurs tell Axios Pro.The big picture: The <a class="gtmContentClick" data-vars-link-text="ACCESS" data-vars-click-url="https://www.axios.com/pro/health-tech-deals/2025/12/05/town-hall-ventures-andy-slavitt-cms-access-digital-health-investors" data-vars-content-id="97529853-1fe5-49c6-af3e-37a4ee2116df" data-vars-headline="Digital health sector sees hope in ACCESS for 2026" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/pro/health-tech-deals/2025/12/05/town-hall-ventures-andy-slavitt-cms-access-digital-health-investors" target="_self">ACCESS</a> program shines a novel spotlight on health tech companies, which have historically faced reimbursement and regulatory obstacles.

Digital health sector sees hope in ACCESS for 2026

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