People with Original Medicare who live with heart failure, chronic obstructive pulmonary disease (COPD), substance use disorders, or nicotine dependence will be able to get technology-supported care at home starting in spring 2027. The Centers for Medicare & Medicaid Services announced the expansion of its ACCESS Model on Sept. 15.
The new tracks join a program that already covers conditions including high blood pressure, diabetes, chronic musculoskeletal pain, and depression. CMS says three in four people with Medicare qualify for at least one ACCESS track. The agency is also extending support for certain bone, joint, and mobility conditions beyond the initial 12-month care period.
For families, the change matters most for aging parents managing conditions that need close attention between doctor visits. It also raises practical questions about cost, eligibility, and privacy that are worth sorting out before the new tracks open.
Four New Condition Tracks Open April 1, 2027
ACCESS, short for Advancing Chronic Care with Effective, Scalable Solutions, is a voluntary 10-year model that began July 5, 2026. According to the CMS ACCESS Model webpage, the new heart failure, COPD, substance use disorder, and tobacco cessation tracks start April 1, 2027. Current participants and applicants will not need to reapply to offer them.
The heart failure track focuses on continuous monitoring aimed at measurable gains in function, symptom management, and quality of life. The COPD track targets lung function, symptom relief, and daily activity. The substance use track covers opioid, alcohol, and other substance use disorders, with integrated support for depression and anxiety that occur alongside them.
Participating organizations may offer virtual care, health coaching, remote monitoring, and connected devices and wearables between regular doctor visits. They send regular updates to a patient's primary care provider or referring clinician, who can bill Medicare a new co-management payment for reviewing that information.
The payment approach is the main break from traditional Medicare. Instead of paying solely for individual services, CMS ties payments to measurable health improvements, such as better blood pressure control, and full payment depends on patients meeting outcome targets. A fixed payment adjustment applies to rural patients in qualifying tracks.
CMS says 160 organizations are participating at launch. Health plans covering 165 million Americans through Medicare Advantage, Medicaid, and private insurance have pledged to adopt an outcomes-based payment structure aligned with ACCESS.
"We built ACCESS because too many people with chronic conditions were falling through the cracks between appointments," CMS Administrator Dr. Mehmet Oz said in the announcement.
Costs, Eligibility, and the Medicare Advantage Exclusion
The most important limit is who can use it. ACCESS is available only to people in Original Medicare. Medicare Advantage enrollees are not eligible, although CMS says their plans may offer similar programs.
That distinction matters this fall. Medicare's annual open enrollment period runs from Oct. 15 to Dec. 7, and anyone weighing a switch between Original Medicare and a Medicare Advantage plan may want to factor ACCESS into that decision.
On cost, Medicare.gov says most participating organizations charge between $0 and $7 a month. An organization helping with multiple conditions cannot charge more than $13 a month in total. Devices such as blood pressure monitors or continuous glucose monitors may be given or loaned at no cost, though some may need to be returned later.
People can sign up directly without a referral, and they keep their current doctors and Medicare benefits. After the first 90 days, they can cancel or switch organizations. Medicare.gov maintains a directory of participating organizations and the conditions each one treats.
CMS also says participating organizations must follow federal HIPAA privacy and security rules and designate a physician to oversee clinical quality and compliance.
Evidence Still Building on Outcome-Based Chronic Care
ACCESS is a test, not a proven program. The model is less than three months old, and CMS has not yet published outcome data. Like other CMS Innovation Center models, it will be formally evaluated.
Independent analysts have urged caution. In a Health Affairs Scholar commentary, Aditya Narayan and Bob Kocher described ACCESS as a novel way to pay for chronic disease care but said it leaves many questions unanswered, including payment levels and how quality will be measured and adjusted for patient risk. The Innovation Center's broader track record is also mixed. A Congressional Budget Office analysis estimated that the center's activities increased federal spending by $5.4 billion from 2011 to 2020, even though the agency had originally projected savings.
CMS plans to publish risk-adjusted outcomes for participating organizations. That public reporting is designed to help patients and referring doctors compare options, but the first results are not yet available.
Practical Steps for Patients and Caregivers
The people most likely to benefit are older adults in Original Medicare with heart failure or COPD who struggle to get to frequent appointments, including those in rural areas with limited local care. People under 65 who have Original Medicare because of a disability may also qualify, including for the substance use track.
Caregivers can start by confirming whether a parent is enrolled in Original Medicare or a Medicare Advantage plan. They can then search the Medicare.gov directory or call 1-800-MEDICARE to ask which organizations serve their area and conditions.
Before signing up, it helps to ask how the organization will share updates with the patient's regular doctor, which devices are included, and whether any monthly fee applies. Patients should not stop prescribed medications or skip regular visits because they joined a remote program. ACCESS is meant to add to existing care, not replace it.
Worsening shortness of breath, chest pain, sudden swelling, or confusion requires urgent medical care, regardless of remote monitoring. People facing a substance use or mental health crisis can call or text 988 to reach the 988 Suicide & Crisis Lifeline.
CMS says it will keep adding participating organizations over the model's 10 years and may consider more conditions later. MedicalDaily will report on participating organizations and early outcome data as CMS releases them.
The expansion could bring more home-based support to millions of older Americans, but it is limited to Original Medicare, and its benefits are still unproven. For now, families can check eligibility and ask questions before enrolling.
Key Questions Answered
What is changing in Medicare's ACCESS model? Starting April 1, 2027, ACCESS will add tracks for heart failure, COPD, substance use disorders, and tobacco cessation, and it will extend support for certain chronic musculoskeletal pain conditions.
What conditions does ACCESS already cover? The model currently covers high blood pressure, diabetes, chronic musculoskeletal pain, and depression, along with related conditions such as high cholesterol, prediabetes, and anxiety.
Can Medicare Advantage members join? No. ACCESS is limited to Original Medicare. Medicare Advantage plans may offer similar programs, so members should contact their plan.
How much does ACCESS cost? Most participating organizations charge $0 to $7 a month, according to Medicare.gov. The total cannot exceed $13 a month when one organization helps with multiple conditions.
Do patients need a referral? No. People can sign up directly with a participating organization, and they keep their existing doctors and Medicare benefits.
Has ACCESS been shown to improve health? Not yet. The model began in July 2026, and CMS has not published outcome results.
Where can people find participating organizations? Medicare.gov maintains a directory, and people can also call 1-800-MEDICARE for help.
