Medicare's ACCESS program, set to launch on July 5, integrates AI into federal healthcare, transitioning from activity-based to outcome-based payment models, with Pair Team among 150 participants.
AI Integration in Healthcare
Pair Team, founded by Neil Batlivala, was accepted into Medicare's ACCESS program. Batlivala noted, “The government is creating swim lanes for AI innovation in traditionally regulated industries.” The program will test AI-driven care at a federal level, focusing on health outcomes for conditions such as diabetes, hypertension, and depression.
Transforming Payment Models
ACCESS rewards measurable health goals, unlike traditional Medicare, which reimburses time spent with a clinician. Batlivala commented, “It’s a payment model transformation.” This model includes predictable payments for managing conditions, creating a mechanism for AI to monitor patients between visits.
Pair Team's Approach
Founded in 2019, Pair Team targets patients with chronic conditions and social challenges. The company employs 850 clinical professionals and has raised $30 million, backed by Kleiner Perkins, Kraft Ventures, and Next Ventures. A study showed significant reductions in avoidable ER visits under Pair Team's care model.
AI's Role in Care
About nine months ago, Pair Team deployed Flora, a voice AI agent, as its primary patient interface. Flora facilitates patient engagement through 24/7 availability and routine hour-long conversations, which Batlivala describes as “both incredible and depressing” for the companionship it offers.
Challenges and Risks
With ACCESS designed by former startup operators Abe Sutton and Jacob Shiff, there are concerns about data privacy and financial risks. The CMS Innovation Center's track record is mixed, with a past increase in federal spending. Batlivala argues low reimbursement rates incentivize AI use, stating, “The economics only work if you’re running a lean, AI-first operation.” Pair Team aims to expand its reach to a million patients within three years.
Source: https://techcrunch.com/2026/05/12/medicares-new-payment-model-is-built-for-ai-and-most-of-the-tech-world-has-no-idea/
