|
| 1 | +# CMS ACCESS Model |
| 2 | + |
1 | 3 | Welcome to the CMS ACCESS Model API Implementation Guide. This comprehensive guide covers all APIs for the CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model. |
2 | 4 |
|
3 | 5 | The ACCESS Model FHIR Implementation Guide (IG) references an Operations Manual that provides more information about the ACCESS Model APIs. |
4 | 6 | A link to the Operations Manuals will be made available soon. |
| 7 | + |
| 8 | +## About the Project |
| 9 | +The ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model is a 10-year voluntary national payment model developed by the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI). Running from July 5, 2026 through June 30, 2036, the ACCESS Model introduces a new Outcome-Aligned Payment (OAP) methodology that reimburses technology-enabled care organizations based on measurable clinical outcomes rather than service volume. The model supports four initial clinical tracks: Early Cardio-Kidney-Metabolic (eCKM), Cardio-Kidney-Metabolic (CKM), Musculoskeletal (MSK), and Behavioral Health (BH). The model is available nationwide across all U.S. states, territories, and the District of Columbia. This repository supports the technical infrastructure, documentation, and operational resources needed to implement and administer the ACCESS Model. |
| 10 | + |
| 11 | +### Project Vision |
| 12 | +The project’s vision is of a healthcare system where Medicare beneficiaries with chronic conditions have equitable access to high-quality care, and where healthcare organizations are rewarded for achieving meaningful, sustained health outcomes. |
| 13 | + |
| 14 | +### Project Mission |
| 15 | +The project mission is to design, implement, and continuously improve the ACCESS Model's technical and operational infrastructure. The project aims to support ACCESS Participants in delivering chronic care services to Medicare beneficiaries, while ensuring program integrity, data transparency, and a seamless experience for participants, beneficiaries, and CMS stakeholders. |
| 16 | + |
| 17 | +### Agency Mission |
| 18 | +The Centers for Medicare & Medicaid Services (CMS) is committed to achieving better care, smarter spending, and healthier people. CMS works to strengthen and modernize the nation's healthcare system by providing access to high-quality care and improved health at lower costs. The CMS Center for Medicare and Medicaid Innovation (CMMI) advances this mission by identifying, testing, and scaling innovative payment and service delivery models that improve quality, reduce costs, and expand access to care for Medicare and Medicaid beneficiaries. |
| 19 | + |
| 20 | +### Team Mission |
| 21 | +The ACCESS Model team is dedicated to building and sustaining a payment and care delivery framework that enables innovative approaches to chronic disease management in Medicare. Our team develops robust technical systems, clear policy guidance, and operational support helping ACCESS Participants to deliver high-quality, outcome-driven care to the patients who need it most. |
| 22 | + |
| 23 | +## Core Team |
| 24 | + |
| 25 | +A list of core team members responsible for the code and documentation in this repository can be found in [COMMUNITY.md](COMMUNITY.md). |
| 26 | + |
| 27 | +<!-- |
| 28 | +## Repository Structure |
| 29 | +
|
| 30 | +TODO: Including the repository structure helps viewers quickly understand the project layout. Using the "tree -d" command can be a helpful way to generate this information, but, be sure to update it as the project evolves and changes over time. |
| 31 | +
|
| 32 | +To install the tree command: |
| 33 | +In the command line |
| 34 | +- MacOS: |
| 35 | +``` |
| 36 | +brew install tree |
| 37 | +``` |
| 38 | +
|
| 39 | +- Linux: |
| 40 | +``` |
| 41 | +sudo apt-get update |
| 42 | +sudo apt-get install tree |
| 43 | +``` |
| 44 | +
|
| 45 | +Windows: |
| 46 | +``` |
| 47 | +choco install tree |
| 48 | +``` |
| 49 | +
|
| 50 | +**{list directories and descriptions}** |
| 51 | +
|
| 52 | +TODO: Add a 'table of contents" for your documentation. Tier 0/1 projects with simple README.md files without many sections may or may not need this, but it is still extremely helpful to provide "bookmark" or "anchor" links to specific sections of your file to be referenced in tickets, docs, or other communication channels. |
| 53 | +
|
| 54 | +**{list of .md at top directory and descriptions}** |
| 55 | +
|
| 56 | +--> |
| 57 | + |
| 58 | +<!-- TODO |
| 59 | +## Development and Software Delivery Lifecycle |
| 60 | +This section provides an overview of how this project typically manages code changes and delivers software updates. It is intended to help contributors understand the general flow of work, not to set mandatory procedures. Programs and teams may adjust these practices to meet their own requirements, governance structures, or release schedules. |
| 61 | +
|
| 62 | +Project team members with write access work directly in this repository. External contributors follow the same general workflow but submit changes through a fork and cannot merge their own pull requests. Additional guidance for contributing is available in: |
| 63 | +[CONTRIBUTING.md](./CONTRIBUTING.md). |
| 64 | +
|
| 65 | +This project aligns with the organization’s common approach to versioning, preparing releases, and communicating updates. Rather than restating those details here, please refer to the OSPO Release Guidelines: |
| 66 | +
|
| 67 | +[Release Guidelines (OSPO Guide)](https://dsacms.github.io/ospo-guide/outbound/release-guidelines/) |
| 68 | +
|
| 69 | +These guidelines outline agency-wide expectations for semantic versioning, release candidates, GitHub releases, and associated review and communication practices. Individual projects may follow this model in full or tailor it to their operational needs. |
| 70 | +--> |
| 71 | + |
| 72 | +## Local Development |
| 73 | + |
| 74 | +<!--- TODO - with example below: |
| 75 | +This project is a monorepo with several apps. Please see the [api](./api/README.md) and [frontend](./frontend/README.md) READMEs for information on spinning up those projects locally. Also see the project [documentation](./documentation) for more info. |
| 76 | +--> |
| 77 | + |
| 78 | +## Coding Style and Linters |
| 79 | + |
| 80 | +<!-- TODO - Add the repo's linting and code style guidelines --> |
| 81 | + |
| 82 | +Each application has its own linting and testing guidelines. Lint and code tests are run on each commit, so linters and tests should be run locally before committing. |
| 83 | + |
| 84 | +<!-- |
| 85 | +## Branching Model |
| 86 | +
|
| 87 | +TODO - with example below: |
| 88 | +This project follows [trunk-based development](https://trunkbaseddevelopment.com/), which means: |
| 89 | +
|
| 90 | +* Make small changes in [short-lived feature branches](https://trunkbaseddevelopment.com/short-lived-feature-branches/) and merge to `main` frequently. |
| 91 | +* Be open to submitting multiple small pull requests for a single ticket (i.e. reference the same ticket across multiple pull requests). |
| 92 | +* Treat each change you merge to `main` as immediately deployable to production. Do not merge changes that depend on subsequent changes you plan to make, even if you plan to make those changes shortly. |
| 93 | +* Ticket any unfinished or partially finished work. |
| 94 | +* Tests should be written for changes introduced, and adhere to the text percentage threshold determined by the project. |
| 95 | +
|
| 96 | +This project uses **continuous deployment** using [Github Actions](https://github.com/features/actions) which is configured in the [./github/workflows](.github/workflows) directory. |
| 97 | +
|
| 98 | +Pull-requests are merged to `main` and the changes are immediately deployed to the development environment. Releases are created to push changes to production. |
| 99 | +--> |
| 100 | + |
| 101 | +## Contributing |
| 102 | + |
| 103 | +Thank you for considering contributing to an Open Source project of the US Government! For more information about our contribution guidelines, see [CONTRIBUTING.md](CONTRIBUTING.md). |
| 104 | + |
| 105 | +## Community |
| 106 | + |
| 107 | +The {{ cookiecutter.project_name }} team is taking a community-first and open source approach to the product development of this tool. We believe government software should be made in the open and be built and licensed such that anyone can download the code, run it themselves without paying money to third parties or using proprietary software, and use it as they will. |
| 108 | + |
| 109 | +We know that we can learn from a wide variety of communities, including those who will use or will be impacted by the tool, who are experts in technology, or who have experience with similar technologies deployed in other spaces. We are dedicated to creating forums for continuous conversation and feedback to help shape the design and development of the tool. |
| 110 | + |
| 111 | +We also recognize capacity building as a key part of involving a diverse open source community. We are doing our best to use accessible language, provide technical and process documents, and offer support to community members with a wide variety of backgrounds and skillsets. |
| 112 | + |
| 113 | +### Community Guidelines |
| 114 | + |
| 115 | +Principles and guidelines for participating in our open source community are can be found in [COMMUNITY.md](COMMUNITY.md). Please read them before joining or starting a conversation in this repo or one of the channels listed below. All community members and participants are expected to adhere to the community guidelines and code of conduct when participating in community spaces including: code repositories, communication channels and venues, and events. |
| 116 | + |
| 117 | +<!-- |
| 118 | +## Governance |
| 119 | +Information about how the **{project_name}** community is governed may be found in [GOVERNANCE.md](GOVERNANCE.md). |
| 120 | +
|
| 121 | +<!-- |
| 122 | +## Feedback |
| 123 | +If you have ideas for how we can improve or add to our capacity building efforts and methods for welcoming people into our community, please let us know at **{contact email}**. If you would like to comment on the tool itself, please let us know by filing an **issue on our GitHub repository.** |
| 124 | +
|
| 125 | +## Glossary |
| 126 | +Information about terminology and acronyms used in this documentation may be found in [GLOSSARY.md](GLOSSARY.md). |
| 127 | +--> |
| 128 | + |
| 129 | +## Policies |
| 130 | + |
| 131 | +### Open Source Policy |
| 132 | + |
| 133 | +We adhere to the [CMS Open Source |
| 134 | +Policy](https://github.com/CMSGov/cms-open-source-policy). If you have any |
| 135 | +questions, just [shoot us an email](mailto:opensource@cms.hhs.gov). |
| 136 | + |
| 137 | +### Security and Responsible Disclosure Policy |
| 138 | + |
| 139 | +_Submit a vulnerability:_ Vulnerability reports can be submitted through [Bugcrowd](https://bugcrowd.com/cms-vdp). Reports may be submitted anonymously. If you share contact information, we will acknowledge receipt of your report within 3 business days. |
| 140 | + |
| 141 | +For more information about our Security, Vulnerability, and Responsible Disclosure Policies, see [SECURITY.md](SECURITY.md). |
| 142 | + |
| 143 | +### Software Bill of Materials (SBOM) |
| 144 | + |
| 145 | +A Software Bill of Materials (SBOM) is a formal record containing the details and supply chain relationships of various components used in building software. |
| 146 | + |
| 147 | +In the spirit of [Executive Order 14028 - Improving the Nation’s Cyber Security](https://www.gsa.gov/technology/it-contract-vehicles-and-purchasing-programs/information-technology-category/it-security/executive-order-14028), a SBOM for this repository is provided here: https://github.com/{{ cookiecutter.project_org }}/{{ cookiecutter.project_repo_name }}/network/dependencies. |
| 148 | + |
| 149 | +For more information and resources about SBOMs, visit: https://www.cisa.gov/sbom. |
| 150 | + |
| 151 | +## Public domain |
| 152 | + |
| 153 | +This project is in the public domain within the United States, and copyright and related rights in the work worldwide are waived through the [CC0 1.0 Universal public domain dedication](https://creativecommons.org/publicdomain/zero/1.0/) as indicated in [LICENSE](LICENSE). |
| 154 | + |
| 155 | +All contributions to this project will be released under the CC0 dedication. By submitting a pull request or issue, you are agreeing to comply with this waiver of copyright interest. |
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