Medicare’s newest chronic care program is about to get bigger. CMS says its ACCESS model will add four conditions on April 1, 2027: heart failure, COPD, substance use disorders and tobacco cessation. Weight is already covered, as part of the program’s first set of conditions.
What ACCESS is
ACCESS stands for Advancing Chronic Care with Effective, Scalable Solutions. It is a voluntary, 10-year model run by the CMS Innovation Center. It began in July 2026. It pays participating organizations to manage long-term conditions for people in traditional Medicare. The care happens between visits, through health coaching, medication management, connected devices and remote monitoring.
The model launched with four tracks. The early cardio-kidney-metabolic track covers high blood pressure, high cholesterol, prediabetes, and obesity or overweight with a marker of central obesity. A second track covers diabetes, stage 3 chronic kidney disease and atherosclerotic heart disease. The other two cover chronic musculoskeletal pain and depression or anxiety.
What changes in April
CMS announced the expansion on Sept. 15. The four new tracks begin April 1, 2027. The same date extends support in the musculoskeletal pain track beyond its first 12 months. Organizations already in the model, or already applying, do not need to reapply to add them. CMS reviews applications on a rolling basis.
Law firm Crowell & Moring reported that 160 organizations were enrolled as of the announcement.
ACCESS does not pay per visit. It makes recurring payments, which CMS calls Outcome-Aligned Payments, for managing a patient’s condition. Full payment depends on how many of an organization’s patients reach their health targets, measured against their own starting point. The minimum share rises each year.
CMS has published payment amounts for the current tracks but not yet for the new ones.
What it means for patients
ACCESS is open only to people in traditional Medicare. Medicare Advantage plans and commercial insurers are not part of it. Joining does not change what Medicare covers outside the model.
If you have traditional Medicare and one of these conditions, a participating practice may offer you this kind of ongoing, between-visit support. Ask your doctor’s office whether it takes part.
Photo: Sculpture “Life in the Community” outside the Woodlawn, Md., headquarters building of the agency now known as CMS. Carol M. Highsmith via Wikimedia Commons, public domain.
Sources
- CMS: ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model
- Foley Hoag: CMS Expands the ACCESS Model: New Tracks for Heart Failure, COPD, Substance Use Disorders, Tobacco (Sept. 2026)
- Crowell & Moring: CMS Expands ACCESS Model to Cover More Chronic Conditions (Sept. 28, 2026)
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