Medicare’s experimental ACCESS model is a pilot program that pays approved companies to deliver technology-enabled management for patients with chronic conditions. The model was announced last year and tests new payment approaches intended to link reimbursement to patient outcomes rather than solely to services provided.
When first launched, ACCESS covered a set of chronic conditions that included diabetes, high blood pressure, chronic musculoskeletal pain, depression, and anxiety. Under the model, approved organizations provide technology-based chronic care management services to eligible Medicare beneficiaries.
Regulators have announced an expansion of the ACCESS pilot to add additional condition tracks. The newly included conditions are substance use disorder, heart failure, chronic obstructive pulmonary disease (COPD), tobacco use, and longer-term support for musculoskeletal conditions. These additions broaden the model’s clinical scope beyond its initial set of chronic conditions.
The announcement states that the new condition tracks are scheduled to begin in spring 2027. Following the expansion, about three in four people on Medicare will be eligible for at least one ACCESS track, according to the report.
A central design feature of ACCESS is the use of outcome-aligned payments: providers and participating companies receive greater payment when their patients’ conditions improve. The model therefore seeks to incentivize clinical improvement rather than volume of services. The source described this structure at a high level but did not provide details in the reported text on the specific outcome metrics, payment amounts, or the mechanics of how performance will be measured and reconciled.
Alongside the expansion announcement, the agency released a directory listing 39 providers who can treat beneficiaries under ACCESS. The directory identifies organizations approved to participate in the model and intended to help beneficiaries and referring clinicians identify participating providers.
The source did not include the names of the 39 providers, their locations, or the criteria used for inclusion in the directory. Additional directory contents and access or enrollment procedures were not reported in the provided material.
The article’s available text lacks several operational and technical details that would be relevant for clinicians and health system leaders considering participation or referral, including:
Those details were not reported in the source and would need to be obtained from CMS materials or follow-up reporting.
The expansion signals Medicare’s continued interest in testing payment models that fund technology-enabled chronic disease management and tie reimbursement to clinical outcomes. By adding common and high-burden conditions such as heart failure, COPD, and substance use disorder, the model aims to reach a larger share of Medicare beneficiaries and to test whether outcome-aligned payments can drive measurable improvement across a wider range of conditions.
Clinicians, health systems, and digital health companies interested in ACCESS should look for the full CMS materials and the provider directory to understand participation criteria, operational requirements, and the specific outcome metrics that will guide payments. The source’s published excerpt did not include that level of operational detail.
Medicare’s ACCESS pilot, originally covering diabetes, hypertension, chronic musculoskeletal pain, depression, and anxiety, will expand to include substance use disorder, heart failure, COPD, tobacco use, and extended musculoskeletal support starting in spring 2027. The model uses outcome-aligned payments, and CMS released a directory of 39 providers approved to treat beneficiaries under the program. Detailed information about the directory contents, payment formulas, and specific outcome measures was not reported in the source.