ACCESS Model Support at Healthie

ACCESS Model support in Healthie lets your organization enroll patients in the CMS ACCESS Model, collect the measures CMS requires, and review, approve, and send reports to CMS. It covers the eCKM and CKM tracks and works at the organization level, so one setup covers your sub-organizations.

What Healthie Supports

Healthie supports the enrollment and reporting work that ACCESS requires. Your organization still applies to CMS and holds the participant agreement.

• Setup: a one-time participant configuration for your organization.
• Enrollment: eligibility checks, enrolling a patient with informed consent, switching between eCKM and CKM, and ending enrollment.
• Data: measures already in Healthie and from connected sources, checked against what each report needs.
• Reporting: a patient list sorted by due date, a report draft for each patient, separate approve and send steps, and the CMS result on the patient page.

Setup

Set up your participant configuration once, on your top-level organization, before you enroll patients.

1. Ask an organization admin to give you the CMS ACCESS permission on your membership.
2. Open the ACCESS setup page.
3. Click Set up.
4. Complete the fields in the Set up modal.
5. Confirm the setup. Healthie checks the connection to CMS and activates the configuration in one step.

Notes:

• Parent and child organizations: a configuration on a parent organization covers every child. Sibling organizations cannot reach each other. Setup is hidden from child organizations, and only a top-level organization can create a configuration.
• CMS credentials: you do not enter, store, or rotate CMS credentials in Healthie.

Retiring a Configuration

Retire a configuration from the same page when your organization leaves ACCESS or needs to replace it. Healthie records the reason and who retired it, and then you can set up a replacement.

Enrolling Patients

Check eligibility and enroll patients from the ACCESS page. Nothing is added to the patient chart when you do.

1. Open the ACCESS page. It opens on the patient list at Due now.
2. Select the track you are working in. The list shows one track at a time.
3. Click Eligibility checks in the list header. The link shows the number of eligible patients.
4. Search for the patient and check eligibility.
5. Record the patient's informed consent. Healthie does not send an enrollment to CMS without it.
6. Click Enroll.

• Medicare Beneficiary Identifier (MBI): if you leave the MBI blank, Healthie uses the newest MBI stored for the patient in your organization. An MBI you type always takes priority. The page shows MBI on file and the last four characters only.
• Switching tracks: you can move a patient between your organization's eCKM and CKM tracks. A patient is in one track at a time.
• Ending enrollment: click End enrollment on the patient's enrollment card.

Measures Healthie Reads

Healthie builds each report from data already in your patient's record and from connected sources.

Blood Pressure Readings

Blood pressure has the most rules because CMS requires device readings and a minimum count.

• Device readings: Healthie reads blood pressure from device sources, not typed entries.
• 15-day window: Healthie includes readings taken in the 15 days before you create the draft. Older readings are rejected.
• Every reading is sent: each accepted reading goes to CMS as its own observation. Healthie does not average them.
• Three readings minimum: CMS rejects a report with fewer than three.
• Devices: the supported blood pressure devices and how they connect to Healthie are not final.

Creating and Sending Reports

Work each report from the patient's page. Drafting, approving, and sending are three separate steps.

1. On the patient list, open a patient from Due now, Upcoming, or All.
2. Review What this report needs. Each measure shows its value, source, and date.
3. Click Create draft.
4. Review the draft and click Approve.
5. Click Send. The page shows the CMS result and the next step.

• Missing required measures: Create draft is disabled, and Healthie refuses approval on the server. There is no option to create a draft anyway.
• Before the reporting window opens: Create draft is disabled and shows the date the window opens.
• Older drafts: update a draft that is more than 24 hours old before you approve it.
• Setup problems: if CMS rejects a report because of a setup issue, fix the setup and click Send again.
• Past reports: open them from the patient's timeline. They are read-only.

What Your Organization Handles

These ACCESS requirements stay with your organization, not Healthie.

• Application: your organization applies to CMS with one Medicare Part B billing number (TIN) and a physician as Clinical Director.
• Patient consent: you collect informed consent before you enroll a patient.
• Blood pressure devices: you choose and supply the devices your patients use.
• Deadlines: you meet the first report, update, and final report deadlines for each patient. See the CKM guide for the dates.
• Care team updates: you send updates to each patient's primary care doctor by secure electronic methods.
• Health information network: you connect to a network CMS accepts.

FAQs

Does Healthie send reports without my approval?

No. A report goes to CMS only after you approve it and click Send.

Can I send a report that is missing a measure?

Not if the measure is required for that report. Waist circumference is optional and never blocks a report.

Does enrolling a patient change their chart?

No. ACCESS enrollment and reports live on the ACCESS page and the patient's ACCESS view.

Do my sub-organizations need their own setup?

No. Set up your top-level organization once. Child organizations use the parent's configuration.

Which blood pressure devices should I buy?

Use the checks in the CKM guide and confirm the device with Healthie before you buy.