Medicare’s new payment model is built for AI, and most of the tech world has no idea

Medicare's new ACCESS program, designed to test AI-driven medical care at a federal scale, introduces a payment model that rewards health outcomes rather than clinician time. This shift, which goes live July 5, allows for reimbursement of AI agents that monitor patients, coordinate care, and ensure medication adherence, something traditional Medicare models couldn't accommodate. Pair Team, a company focused on chronic condition management for underserved populations, is among the 150 participants selected for this 10-year program. Their AI voice agent, Flora, has proven effective in patient engagement, even providing companionship. The program's architects, former startup operators within CMS, designed it with outcome-based payments and competition in mind. While there are risks, including data security and mixed track records of CMS innovation programs, the low reimbursement rates are seen by participants like Pair Team as an incentive to build efficient, AI-first operations. The broader tech world has largely overlooked this significant development, despite a surge in digital health funding.

(Source：TechCrunch)