ACCESS Model Informed Consent


Cercanos Care participates in the CMS ACCESS Model, a Medicare payment model that runs from July 5, 2026 through June 30, 2036. This summary covers the key points of your participation. The full ACCESS Model Informed Consent is available on request and is part of your record.

1. About This Program

2. Clinical Tracks

ACCESS has four clinical tracks. Cercanos Care offers the three below (the Musculoskeletal track is not offered). Your care team will check the track(s) that apply to you. You may not be enrolled in both eCKM and CKM at the same time.

Track Qualifying Conditions
  eCKM: Early Cardio-Kidney-Metabolic Hypertension; dyslipidemia; obesity/overweight with central adiposity; prediabetes
  CKM: Cardio-Kidney-Metabolic Diabetes mellitus; chronic kidney disease (Stage 3a to 3b); atherosclerotic cardiovascular disease
  BH: Behavioral Health Depression and/or anxiety disorders

3. Your Rights – No Cost to You

4. Your Health Information

5. Control Group

To measure how well the program works, CMS randomly assigns some people who try to enroll to a control group. In the first year, about 1 in 10 people (a 90:10 ratio) are assigned to the control group. If you are assigned to the control group, you cannot enroll in this ACCESS track for 12 months. Your Medicare benefits, rights, and coverage are not affected in any way, and you can keep seeing your usual doctors. Cercanos Care will notify you of your assignment.

6. Consent and Electronic Signature

By completing the fields below and signing, I confirm that:


Auto
Draw your signature above using mouse or touch

Complete the section below only if signing on behalf of the patient as an authorized representative.

Contact Information

Cercanos Care
8600 NW 36th St, Suite 501 · Doral, FL 33166 · 305-831-2358
privacy@cercanoscare.com · www.cercanoscare.com · innovation.cms.gov/innovation-models/access

Retain in the patient record. Summary Version: September 2026, Cercanos Care Compliance Office