The CMS Innovation Center has run payment experiments for 15 years. Most paid providers for activity: enrolling patients, filing reports, hitting process measures. At the end of 2025, CMS launched a model that changes the unit of payment itself. It’s called CMS ACCESS, and it pays for outcomes. Did blood pressure come down? Did HbA1C come down? Did depression scores improve? The first cohort went live weeks ago.

Underneath that idea is a much harder one. To pay for outcomes, you have to measure outcomes at the patient level, across thousands of organizations, in something close to real time. As host Lisa Bari puts it, this is a data problem before it’s a policy problem. Her guest is Dr. Will Gordon, who was the first Chief Informatics Officer at the CMS Innovation Center and a senior advisor to the CMS Administrator on technology and intero ...