“The government is creating swim lanes for AI innovation in traditionally regulated industries,” he told me over a Zoom call a few days later. “The best solution wins, which, in regulated industries like healthcare — that’s not been the case.”

ACCESS — Advancing Chronic Care with Effective, Scalable Solutions — is a 10-year CMS program testing a payment model that rewards health outcomes rather than required activities (like a certain number of check-ins). Participating organizations like Pair Team receive predictable payments for managing qualifying conditions and earn the full amount only when patients meet measurable health goals, like lower blood pressure or reduced pain. It covers diabetes, hypertension, chronic kidney disease, obesity, depression, and anxiety.

Traditional Medicare reimburses based on time spent with a clinician. There’s no mechanism to pay for an AI agent that monitors a patient between visits, calls to check in, coordinates a housing referral, or makes sure someone picks up their medication. ACCESS creates that mechanism for the first time.

“It’s a payment model transformation,” Batlivala said. “You just couldn’t do this before.”