In December 2025, the CMS Innovation Center introduced the ACCESS model, a new framework designed to accelerate the shift from fee-for-service to outcomes-based care. ACCESS targets the conditions driving the largest share of U.S. healthcare spending: enhanced and standard chronic kidney management (eCKM and CKM), musculoskeletal care (MSK), and behavioral health (BH).
Under ACCESS, participating organizations are paid through Outcome-Aligned Payments (OAPs) tied to measurable improvements in patient health. The model also formalizes co-management between ACCESS participants and referring primary care physicians, recognizing how chronic conditions are actually managed across a fragmented network.
CMS received over 350 applications. 173 organizations were accepted into the first cohort, which goes live July 2026.
Participation in ACCESS isn't just a clinical commitment. It's a technical one. Among the most demanding requirements is connectivity to a health information exchange (HIE), a network that aggregates longitudinal patient data across hospitals, clinics, labs, and pharmacies. The HIE connection must support timely, reciprocal exchange of clinical information with all providers involved in a beneficiary's care.
Founded in early 2025 by Juan Estrada, MD and Ignacio Arabeity, Cercanos Care is a virtual-enabled cardiometabolic and behavioral health company purpose-built for the Hispanic community. Cercanos supports health plans, employer groups, and at-risk provider groups serving commercial, Medicare Advantage, and Original Medicare beneficiaries (including those attributed to Accountable Care Organizations). That population represents roughly 20% of the U.S., yet has historically been overlooked.
"Our patients see their doctor two, maybe three times a year. That leaves over 300 days where care is happening outside the exam room. Metriport gives us the clinical context to make those days count."
— Juan Estrada, MD, CEO and Co-Founder, Cercanos Care
Hispanic adults are 60% more likely to be diagnosed with diabetes and face 1.5x higher mortality from the disease. Nearly 46% live with obesity. Cercanos exists because these communities deserve care designed for them, not adapted as an afterthought.
Cercanos operates a co-management model alongside community primary care physicians across Florida, Texas, Nevada, Arizona, Tennessee, North Carolina, and Puerto Rico. They don't replace the PCP, but fill the 300+ days between visits with bilingual clinical support, health coaching, pharmacist oversight, nutritional guidance, behavioral health intervention, and SDOH navigation.
"Speaking the language is one piece. To change behavior, you have to build a relationship, which means understanding what people eat, where they shop, how their family environment works. It's the entire ecosystem that drives change."
— Juan Estrada, MD, Co-Founder, Cercanos Care
Cercanos was built on value-based care from day one, which made ACCESS a natural fit. In April 2026, Cercanos was accepted into the first ACCESS cohort, participating across the eCKM, CKM, and Behavioral Health tracks.
"What struck me about Cercanos was how deeply they understand their patients. Not just clinically but culturally. That kind of care is hard to build. We wanted to make sure the infrastructure never got in the way of it."
— Dima Goncharov, Co-Founder and CEO, Metriport
As an outcomes-oriented organization, the numbers speak for themselves. Cercanos tracks quality, operational, clinical, and utilization outcomes:
Outcomes summary titled "Cercanos Care, by the numbers," organized into three rows. Clinical control: 75% A1C control, 85% blood pressure control, 50% BMI improvement. Utilization: 48% ED visit reduction, 60% hospitalization reduction. Experience: 98.5 patient NPS, 100.0 provider NPS.
A typical Cercanos patient has a community PCP, a cardiologist, an endocrinologist, and a behavioral health provider, each holding different pieces of the clinical story. Lab results here. Medication lists there. Hospital discharge summaries somewhere else.
The biggest challenge is visibility into acute events. As a value-based care company, Cercanos needs to know immediately when a patient shows up in the ER or is admitted to a hospital. Without that visibility, care teams cannot intervene with proper transitions of care, cannot prevent the next visit, and cannot close the loop. In an outcomes-focused model, that visibility is everything.
Before Metriport, record retrieval at Cercanos followed the standard playbook: fax requests, phone calls, patient portals, and asking patients to bring records to their appointments. For a virtual-first organization, that friction created real delays. Every day spent waiting on records was a day Cercanos could not fully activate a patient in the program. For cardiometabolic patients especially, delays in medication reconciliation or A1C history have a direct impact on care quality.
What the Cercanos leadership team understood from years in advanced primary care is that HIE connectivity isn't something to take on yourself. Building those connections in-house diverts months of engineering and compliance work away from the clinical mission, and the result is rarely as comprehensive as a purpose-built platform can deliver.
"We knew connecting directly to an HIE is a slow, complex process, so we set out to find a platform with connectivity included. Metriport made it easy to obtain all this relevant data in a timely manner for us to better coordinate patient care."
— Ignacio Arabeity, Co-Founder, Cercanos Care
Metriport is an open-source healthcare interoperability platform that connects to every major national HIE network and a wide range of regional HIEs. Through a single API, ACCESS participants get longitudinal clinical records, ADT alerts, pharmacy and lab data, and bidirectional data flow back to the network.
What stood out to Cercanos wasn't just connectivity coverage; it was the depth of clinical data that came back.
"Most ADT feed companies send you alerts but leave out the clinical information. It's helpful to know that a patient went to the ER, but I need the discharge note, the medication changes, the follow-up instructions. Metriport gives me the full picture I need to recommend care."
— Juan Estrada, MD, CEO and Co-Founder, Cercanos Care
When a patient is enrolled and moves into activation in the Cercanos program, the team triggers a Metriport query to pull the complete medical history: prior A1C values, blood pressure trends, current medications, hospital discharge details. That's the information care teams need to have a meaningful first conversation with the patient and their PCP.
Care coordination isn't optional under ACCESS; it's required. Participants must work with the referring PCP and the broader community of clinicians involved in each patient's care. For Cercanos, whose entire model is built around co-management with community physicians, that visibility is essential.
Metriport surfaces available care team information alongside each patient's consolidated medical records. A Cercanos clinician opening a patient's record can see the referring PCP, the specialists involved, and the contact information needed to loop them in.
We need to understand the network where the patient is being managed. When Cercanos co-manages a patient, ACCESS unlocks payments for community providers who review our progress updates. Every way we can complement the data received by the care team ultimately helps the patient.
— Ignacio Arabeity, Co-Founder, Cercanos Care
Three outcomes stand out since integrating Metriport into Cercanos' clinical workflows:
1. Time to patient activation has dropped significantly. Cercanos can move patients from enrolled to fully activated much faster because the team is no longer waiting on records.
2. Clinical quality has improved. Care teams start with the complete picture (prior labs, medication history, recent hospitalizations) from the first patient interaction.
3, Real-time visibility into acute events. Cercanos now knows when a patient visits the ER or is admitted to a hospital, enabling timely transitions of care, PCP coordination, and prevention of the next acute event.
"HIE connectivity for ACCESS isn't a one-time integration; it's an ongoing operational requirement. We made sure Cercanos had everything they needed to go live with confidence."
— Colin Elsinga, Co-Founder and COO, Metriport
Metriport's bidirectional data exchange is foundational to how Cercanos' co-management model actually works. The community PCP can see what Cercanos' remote care teams are doing. Cercanos can see what happens in the primary care visit.
July 2026 is a major milestone. Cercanos is in the first cohort of the CMS ACCESS Model, participating across eCKM, CKM, and Behavioral Health tracks. ACCESS represents real progress from fee-for-service toward outcomes-based measurement and payments, which is exactly what Cercanos was built to do.
Having reliable, automated record retrieval through Metriport is not a nice-to-have for this kind of work. It is a core operational requirement.
But Cercanos' growth isn't limited to ACCESS. The company is scaling across different payer and provider groups across the U.S. Every new market, every new health plan contract, every new PCP partnership means more patients with fragmented records who need a unified clinical picture. Metriport is the infrastructure that makes that possible as Cercanos grows.
"ACCESS is progress from fee-for-service toward outcomes-based payments. That is what Cercanos was built to do. Metriport gives us the infrastructure to deliver on that promise as we scale across payers and markets nationwide."
Ignacio Arabeity, Co-Founder, Cercanos Care
ACCESS participants preparing for July 2026 can schedule an HIE readiness consultation with the Metriport team.
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