WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services will expand its outcome-based ACCESS payment model in spring 2027 to cover heart failure, chronic obstructive pulmonary disease, substance use disorders and tobacco cessation, extending technology-supported chronic care to more people with Original Medicare.
The Advancing Chronic Care with Effective, Scalable Solutions model allows participating organizations to provide services such as virtual care, health coaching, remote monitoring, connected devices and wearables between traditional medical visits. Rather than paying solely for individual services, CMS ties full payment to measurable improvements in patients’ health.
CMS currently offers ACCESS tracks for conditions including high blood pressure, diabetes, chronic musculoskeletal pain and depression. The agency says more than three-quarters of people with Medicare qualify for at least one track.
The expansion adds continuous monitoring and support for heart failure, with an emphasis on function, symptoms and quality of life, while the COPD track is intended to maintain or improve lung function, reduce symptoms and support daily activities.
CMS will also add comprehensive care for opioid, alcohol and other substance use disorders, including support for patients who also have depression or anxiety, along with a track focused on tobacco cessation. Support for certain chronic musculoskeletal conditions will be extended beyond the model’s initial 12-month care period.
“We built ACCESS because too many people with chronic conditions were falling through the cracks between appointments,” CMS Administrator Mehmet Oz said. He said the model gives patients and providers access to technologies including remote monitoring and connected devices while rewarding providers for achieving health outcomes.
The model is designed to work alongside patients’ existing healthcare providers. Primary care and other clinicians can refer eligible Medicare beneficiaries to participating ACCESS organizations, which can coordinate with the patient’s broader care team.
Participation is voluntary and does not change a beneficiary’s underlying Medicare benefits, coverage or freedom to choose providers. ACCESS is available to people enrolled in Original Medicare; Medicare Advantage members are not eligible for the model, though their plans may offer comparable programs.
More than 160 healthcare organizations are participating in ACCESS, and CMS plans to continue adding participants during the model’s 10-year run. The agency maintains a directory of participating organizations and covered conditions at Medicare.gov/ACCESS.
Health insurers representing about 165 million people across Medicare Advantage, Medicaid and commercial insurance have also pledged to offer payment arrangements aligned with ACCESS, according to CMS. Eighteen clinical and patient organizations have expressed support for expanding technology-supported chronic care.
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