CMS Adds Medicare Options to Help People Manage Substance Use Disorder, Heart Failure, and Other Common Chronic Conditions

ACCESS Model Now Available to People with Original Medicare

Starting in Spring 2027, the Centers for Medicare & Medicaid Services (CMS) will expand an existing initiative to offer technology-supported care options to Medicare beneficiaries who have heart failure, chronic obstructive pulmonary disease (COPD), substance use disorders, and nicotine dependence. With these additions, CMS will enable more people with common chronic conditions and Original Medicare to receive ongoing care, designed to help them improve their health and stay independent, from the comfort of their homes.

This disease management support is made possible by the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model. The model supports CMS’s work on modernizing the nation’s digital health ecosystem and empowering Medicare beneficiaries through greater access to innovative health technologies. ACCESS uses a new payment approach that emphasizes achieving specified health outcomes. Instead of paying solely for individual services, CMS ties payments directly to measurable improvements in patient health.

“We built ACCESS because too many people with chronic conditions were falling through the cracks between appointments,” said CMS Administrator Dr. Mehmet Oz. “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.”

The ACCESS Model enables participating organizations to potentially provide virtual care, health coaching, remote monitoring, and connected devices and wearables between regular doctor visits. It is designed to integrate with the broader healthcare system, enabling healthcare professionals, such as those in primary care, to refer people with Medicare to ACCESS participants who will work with their care team. Participation is completely voluntary and does not negatively alter a beneficiary’s Medicare benefits, coverage, or provider choice.

The ACCESS Model currently offers care options for people with chronic conditions, including high blood pressure, diabetes, chronic musculoskeletal pain, and depression. Three out of four people with Medicare qualify for at least one ACCESS track.

CMS will grow the ACCESS Model across several areas:

- Heart failure: Supporting eligible patients with continuous monitoring focused on measurable gains in function, symptom management, and quality of life.

- Chronic obstructive pulmonary disease: Offering targeted support to help maintain or improve lung function, ease symptoms, and support day-to-day activities.