Blue Shield of California expects to introduce chronic-care models in its commercial plans in 2027, taking inspiration from Medicare’s new ACCESS experiment. The insurer has not finalized how its version will work: as of an October 1, 2026 report by STAT, it was still deciding whether to use Medicare’s payment amounts and which care organizations to partner with. The commercial plan should therefore be understood as a proposal in development, not a launched program or a confirmed copy of Medicare’s model.
What Blue Shield of California has said so far
STAT reported on October 1, 2026 that Blue Shield of California, which the report said serves 6 million members, expects to launch similar models in commercial plans in 2027. The insurer’s chief medical officer, Ravi Kavasery, told the publication that payment amounts and participating care organizations were still under consideration.
That leaves several practical details unresolved: the conditions members may be able to receive care for, how eligibility and enrollment will work, what outcomes providers will be accountable for, and how those outcomes will be reported. The available account also does not establish whether the commercial version will use CMS’s payment amounts or simply follow the same broad payment principles. No vendor or operating design has been announced in the cited reporting. STAT’s October 1 report is the source for the expected launch and the insurer’s unsettled plans.
What Medicare’s ACCESS experiment is testing
ACCESS means Advancing Chronic Care with Effective, Scalable Solutions. CMS describes it as a voluntary, 10-year Original Medicare model testing outcome-aligned payments for technology-supported care. It began July 5, 2026 and is scheduled to run through June 30, 2036. CMS’s model page and its technical FAQ explain the model’s design and schedule.
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The payment experiment changes what Medicare rewards. Traditional fee-for-service generally pays for specified activities and devices, while ACCESS tests recurring payments to eligible care organizations for managing a qualifying condition. Full payment is tied to measurable improvement or control relative to a patient’s starting point, rather than merely completing a defined service or supplying a device. CMS uses a 15 mmHg reduction in blood pressure as an example of a possible target; it is not a universal target for every patient or condition.
Care can combine clinician consultations with nutrition or exercise support, behavioral support, counseling, education, care coordination, medication management, diagnostic testing, and FDA-authorized devices or software. Delivery may be in person, virtual, asynchronous, or through another clinically appropriate technology-enabled approach. Participating organizations must be Medicare Part B-enrolled providers or suppliers, meet state licensing and applicable HIPAA and FDA requirements, and appoint a physician clinical or medical director. CMS says it will monitor performance and publish risk-adjusted outcomes.
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Who and what Medicare’s model covers
ACCESS is for qualifying people with Original Medicare. Medicare Advantage members are not included in the model itself, although a private insurer may separately offer a similar program to its own members. Participation by beneficiaries is voluntary: people retain their regular Medicare services and can continue seeing any Medicare provider.
The initial ACCESS tracks cover four areas:
- Early cardio-kidney-metabolic (eCKM): hypertension; dyslipidemia; obesity or overweight with a central-obesity marker; and prediabetes.
- Cardio-kidney-metabolic (CKM): diabetes; stage 3a or 3b chronic kidney disease; and atherosclerotic cardiovascular disease, including heart disease.
- Musculoskeletal (MSK): chronic musculoskeletal pain.
- Behavioral health (BH): depression and anxiety.
CMS says additional tracks for heart failure, COPD, substance use disorder, tobacco cessation, and a follow-on chronic musculoskeletal pain track are scheduled to start April 1, 2027. Organizations already participating or applying will not need to reapply for those tracks. These are CMS’s Medicare model categories; they do not establish which conditions Blue Shield will include in its commercial offering.
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How ACCESS fits with a patient’s usual care
CMS designed ACCESS to complement—not replace—traditional care. Participating organizations share care plans and updates with primary-care and referring clinicians. Those clinicians may bill a co-management payment for reviewing updates and documenting coordination. The model does not require a beneficiary to give up access to other Medicare providers.
CMS will evaluate the model’s quality and Medicare spending. Its 10-year duration and participant count do not show that it has already improved health outcomes or reduced costs. Any expansion or permanence would depend on the evaluation and certification conditions CMS describes, rather than being guaranteed by the model’s launch.
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How the Medicare model differs from Blue Shield’s proposal
| Question | CMS ACCESS | Blue Shield of California’s expected commercial models |
|---|---|---|
| Who is covered? | Qualifying people with Original Medicare; Medicare Advantage is excluded from ACCESS. | Commercial-plan members are the stated focus; exact eligibility rules are not stated in the October 1, 2026 STAT report. |
| Which conditions? | Four initial tracks: eCKM, CKM, chronic musculoskeletal pain, and depression and anxiety, with further tracks scheduled for April 1, 2027. | Not stated in the October 1, 2026 STAT report. |
| How are payments set? | CMS is testing recurring Outcome-Aligned Payments, with full payment tied to measurable outcomes. | Whether Blue Shield will use CMS payment amounts was still being decided, according to STAT on October 1, 2026. |
| Which care organizations participate? | Organizations must meet CMS participation requirements, including Medicare Part B enrollment and clinical oversight. | Not stated; Kavasery told STAT the insurer was still deciding which organizations to work with. |
| When does it start? | ACCESS began July 5, 2026 and is scheduled to operate through June 30, 2036. | Blue Shield expects a 2027 launch; a more specific date was not stated in the October 1, 2026 report. |
The wider payer pledge does not mean every plan has launched
Blue Shield’s plans sit within a broader voluntary effort. CMS reported on February 12, 2026 that health payers representing more than 165 million people across Medicare Advantage, Medicaid, and private coverage had pledged to offer payment arrangements aligned with ACCESS’s core principles by January 1, 2028. The signatories listed by CMS include Blue Shield of California and national and regional insurers such as Centene, Cigna, CVS Health, Humana, and UnitedHealthcare; CMS later added Baylor Scott & White Health Plan, TriWest Healthcare Alliance, and BCBS Rhode Island. CMS’s pledge announcement describes the commitment.
The pledge is a commitment to offer aligned arrangements, not evidence that every signatory has already launched one, nor that all will adopt CMS’s exact rates. CMS said optional alignment resources were being developed, including sample provider-agreement structures, standardized billing codes, and FHIR-based reporting infrastructure; the cited announcement does not establish that those resources are now available.
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What to watch for before the commercial launch
The Medicare experiment supplies a framework, but Blue Shield’s version will only become clear when the insurer publishes its design. The most consequential details for members and clinicians will be:
- Which commercial plans and members qualify, and whether enrollment is voluntary.
- Which conditions and care organizations are included.
- Whether payments use CMS amounts or a separate commercial rate structure.
- Which outcomes are measured, how progress is reported, and how clinicians coordinate with existing care teams.
- The precise launch date and any plan-specific steps members need to take.
CMS’s participant directory reports more than 160 participating health care organizations, a scale figure that may change as the directory is updated. It is not evidence of Blue Shield’s partner selection or of proven ACCESS results. CMS’s participant page identifies organizations in the Medicare model.
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