CMS said it will expand its ACCESS model in the spring of 2027 to cover four additional conditions for traditional Medicare beneficiaries: heart failure, COPD, substance use disorders and tobacco cessation. The additions build on existing tracks including high blood pressure and diabetes and, according to CMS, raise the model’s potential reach to roughly three in four Medicare beneficiaries.
ACCESS, short for Advancing Chronic Care with Effective, Scalable Solutions, launched in July as a 10-year test through CMS' Innovation Center. The model allows participating providers to use digital tools, nontraditional services and care teams that are not typically reimbursed under fee-for-service, while tying providers to responsibility for quality and total cost of care.
What is changing
CMS said 160 providers are participating in the program. Those organizations can share in savings if they improve outcomes and reduce spending.
The new substance use disorder track will include support for opioid and alcohol use disorders, along with co-occurring depression and anxiety. CMS tied those additions to the Trump administration's Great American Recovery initiative.
CMS is also extending its musculoskeletal pain track so that patients with certain conditions can continue receiving support beyond the model’s initial 12-month care period.
Why it matters
The ACCESS model is designed to test whether outcome-based payments can encourage more consistent use of remote monitoring and virtual care for chronic conditions, while shifting care toward prevention, continuous engagement and technology-enabled support rather than episodic visits. That makes this expansion more than a coverage update: it broadens the set of clinical areas where providers can build care pathways around services that fee-for-service Medicare does not usually reimburse.
For the market, the practical signal is that CMS is giving providers a larger policy sandbox for AI-enabled technologies, connected devices and remote monitoring without changing the model’s core financial logic. The model still rewards organizations only if those tools translate into better outcomes and lower overall spending.
That distinction matters. Broader eligibility may help digital health vendors reach more patients, but the stronger strategic effect is on providers willing to take accountability for cost and quality across chronic disease populations that are expensive, persistent and often poorly served by visit-based care.
Limits of the model
The ACCESS model remains limited to beneficiaries with traditional Medicare; people enrolled in Medicare Advantage are not eligible to participate. CMS also said it will continue accepting new participating organizations on a rolling basis throughout the 10-year run.
The next test is execution. Expanding to more conditions increases the addressable population, but the model’s real policy value will depend on whether the new tracks produce measurable outcome gains rather than simply wider use of digital care tools.
