Less than three months after the start of the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model, the Centers for Medicare & Medicaid Services (CMS) announced that it is expanding the program to include additional chronic conditions.
Speaking at Building a Healthier America: CMS ACCESS and a New Chapter in Health Innovation on September 15, 2026, Abe Sutton, the Director of CMS’s Center for Medicare & Medicaid Innovation (CMMI) said, “We’re prepared to expand ACCESS’s impact even further, bringing the approach to more American families.”
ACCESS originally included four tracks: early cardio-kidney-metabolic, cardio-kidney-metabolic, musculoskeletal, and behavioral health.
Beginning April 1, 2027, the model will add tracks for heart failure, chronic obstructive pulmonary disease (COPD), substance use disorders, and tobacco cessation. CMS will also add a follow-on period for certain chronic musculoskeletal conditions. According to a CMS press release, three out of four people with Medicare already qualify for at least one ACCESS track.
Payments for Technologies
As Applied Policy previously reported, ACCESS tests a new approach to paying for technology-supported care.
Participating organizations in ACCESS have flexibility in how they help beneficiaries achieve specified outcomes, including through remote monitoring, medication management, nutrition support, digital therapeutics, and other technology-supported approaches.
At the September event, CMS Administrator Dr. Mehmet Oz observed that ACCESS allows for greater recognition of differences among individual patients.
“It is incredibly frustrating if you’re a physician and you’ve got a quality standard that you know doesn’t apply to your patient,” Oz said. He characterized ACCESS as moving care delivery away from “a box-checking exercise.”
ACCESS is also designed to support coordination with beneficiaries’ other healthcare providers. CMMI’s Chief AI and Technology Officer, Jacob Shiff said primary care providers, specialists, rural and federally qualified health centers, pharmacies, and other clinicians can refer patients to ACCESS organizations, receive ongoing updates, and bill for co-management. He added that the model can work alongside risk-bearing arrangements in which clinicians already participate, including accountable care organizations.
Dr. Jennifer Brull, board chair of the American Academy of Family Physicians, echoed Shiff in her comments as part of a panel of clinical society leaders convened during the event.
“The potential for ACCESS is when I have a patient who needs increased support, and I have a trusted organization who can partner with me for that support,” Brull said. “That’s incredibly valuable, especially in those spaces that happen outside the clinic walls.”
Clinicians do not have to participate in the model to receive co-management payments, according to CMS. The agency’s billing guidance explains how the payments work. Eligible Medicare Part B practitioners may bill $30 when they review a care update from an ACCESS organization and take at least one related care coordination step, such as reconciling medications or updating follow-up instructions. They may bill up to three times in a 12-month period per beneficiary for each ACCESS track. Guidelines also allow an additional $10, billed with the first co-management claim, for helping a beneficiary enroll and set up a device or app.
Four New Tracks
The newly announced tracks will extend ACCESS to additional conditions.
The heart failure track will support eligible beneficiaries with continuous monitoring focused on improved function, symptom management, and quality of life.
The new COPD track will focus on helping beneficiaries manage chronic obstructive pulmonary disease, including improving lung function, symptoms, and the ability to perform daily activities.
The substance use disorder track, which aligns with the Trump Administration’s larger Great American Recovery Initiative, will include opioid use disorder, alcohol use disorder, and other substance use disorders. Participating organizations will be expected to provide comprehensive treatment, including support for co-occurring depression and anxiety.
ACCESS will also add a tobacco cessation track for beneficiaries seeking to stop the use of tobacco products.
For beneficiaries receiving care for certain chronic musculoskeletal conditions, CMS is taking a somewhat different approach. Rather than establishing an entirely new clinical area, the agency will create a follow-on period allowing eligible beneficiaries to continue receiving support after completing the initial 12-month ACCESS care period.
Importantly, organizations already participating in ACCESS, as well as current applicants, will not have to submit another application to participate in the new tracks.
Early Numbers
Shortly after announcing the model in December 2025, CMS reported that more than 350 technology-enabled care organizations had submitted their intent to apply. As of September, more than 160 organizations were participating in the model, including virtual-first specialty practices, wearable-device companies, and app developers.
During the September event, Shiff said the ACCESS directory at Medicare.gov was live with care options from nearly 40 organizations and that “thousands of beneficiaries have already enrolled.”
CMS has said it will continue to add participating organizations during ACCESS’s 10-year performance period.
Extending the ACCESS Framework Beyond Original Medicare
Although ACCESS itself serves beneficiaries enrolled in Original Medicare, CMS has also been encouraging other payers to adopt payment approaches based on the model.
In February, CMS announced that health plans representing more than 165 million people had pledged to offer outcome-based payment arrangements aligned with ACCESS across Medicare Advantage, Medicaid, and commercial insurance. CMS is making available optional resources to facilitate that alignment, including a sample provider agreement structure, standardized billing codes, and reporting infrastructure based on the Fast Healthcare Interoperability Resources (FHIR) standard.
The September announcement added another element to that effort.
Shiff said that CMS will be publishing a reference specification for a maternal cardio-kidney-metabolic track, including hypertensive disorders of pregnancy. Unlike the four new ACCESS tracks, the maternal specification will not be an Original Medicare ACCESS track. Instead, CMS is developing it as a voluntary reference that other payers, including Medicaid plans, can use to develop outcome-aligned payment arrangements.
“What ACCESS is testing is bigger than any one model,” Sutton said. “It’s whether we can make innovation a force for better health and more affordable care. That’s the future we’re working towards.”
