Photo: Kevin Dietsch/Getty Images
The Centers for Medicare and Medicaid Services (CMS) announced on Tuesday that the agency will be expanding efforts to provide more options to Medicare beneficiaries with heart failure, chronic obstructive pulmonary disease (COPD), substance use disorders, and nicotine dependence. This extra support is made possible through the agency’s Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model.
CMS explained in a press release that the model supports the agency’s “work on modernizing the nation’s digital health ecosystem and empowering Medicare beneficiaries through greater access to innovative health technologies.” The model uses a new payment method that “ties payments directly to measurable improvements in patient health” rather than just paying for individual services.
CMS Administrator Dr. Mehmet Oz stated that ACCESS will ensure more people receive the assistance that they need.
“We built ACCESS because too many people with chronic conditions were falling through the cracks between appointments,” Dr. Oz said. “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.”
Health organizations that participate in ACCESS will be able to “potentially provide virtual care, health coaching, remote monitoring, and connected devices and wearables between regular doctor visits.” CMS explained that participation in ACCESS is voluntary and “does not negatively alter a beneficiary’s Medicare benefits, coverage, or provider choice.”
ACCESS currently has care options for chronic conditions such as high blood pressure, diabetes, chronic musculoskeletal pain, and depression. The model will be expanding options for patients with heart failure, chronic obstructive pulmonary disease, substance use disorders, tobacco cessation, as well as providing expanded support for bone, joint and mobility conditions.
The changes are set to take effect spring. Care options for heart failure will notably include “supporting eligible patients with continuous monitoring focused on measurable gains in function, symptom management, and quality of life.” Services for substance use disorders will include “comprehensive care for opioid, alcohol, and other substance use disorders, including integrated support for co-occurring depression and anxiety, consistent with President Trump’s Great American Recovery initiative.”
CMS previously explained that the ACCESS Model “is a 10-year national test of a new payment approach designed to expand access to technology-supported care for people with chronic conditions.” This model provides “participating organizations with predictable, recurring payments for helping patients manage qualifying chronic conditions” with full payment depending on “achieving measurable health outcomes, such as improvement or control of blood pressure for hypertension.
ACCESS launched on July 5, 2026, and will operate for a total of 10 years. The agency stated that the number of organizations participating in ACCESS is now 160 and will continue to grow over the next decade. A list of participating organizations can be found at Medicare.gov/ACCESS.
Comments