Starting in the spring of 2027, CMS will expand its ACCESS model to cover four new conditions for traditional Medicare beneficiaries. The program will include heart failure, COPD, substance use disorders and tobacco cessation, adding to existing tracks like high blood pressure and diabetes.
ACCESS stands for Advancing Chronic Care with Effective, Scalable Solutions. The program, which launched in July, allows providers to use digital tools, nontraditional services and care teams that are not typically reimbursed under fee-for-service. Participating providers, of which there are 160, take on responsibility for quality and the total cost of care, with the opportunity to share in savings if they improve outcomes and decrease spending.
The program was established as a 10-year test of CMS’ Innovation Center, designed to evaluate whether outcome-based payments can encourage more consistent use of remote monitoring and virtual care for chronic conditions. It also aims to promote prevention, continuous engagement and technology-enabled care rather than episodic visits.
With the expansion, CMS estimates that roughly three in four Medicare beneficiaries will now qualify for at least one ACCESS track.
The model’s substance use disorder track will fold in support for opioid and alcohol use disorders, along with co-occurring depression and anxiety, which are additions that CMS has tied to the Trump administration’s Great American Recovery initiative.
CMS is also extending its musculoskeletal pain track, which will allow patients with certain conditions to keep receiving support beyond the model’s initial 12-month care period.
“ACCESS is one of the tools we are using to bring healthcare into the digital age, giving patients and their providers greater access to AI-enabled technologies, remote monitoring, connected devices and other innovative tools that can help identify problems earlier and improve care. This latest expansion of the program will help more Americans get the care they need and reward providers who deliver actual results,” CMS Administrator Mehmet Oz said in the agency’s Tuesday announcement.
The ACCESS model remains limited to beneficiaries with traditional Medicare, with people enrolled in Medicare Advantage not eligible to participate.
CMS said it will continue accepting new participating organizations on a rolling basis throughout the model’s 10-year run.
Whether the expanded tracks translate into meaningful outcome improvements or just broader access to digital health tools will likely become clearer as the new cohorts get underway next year.
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