Beginning April 1, 2027, people with Original Medicare who have heart failure, chronic obstructive pulmonary disease, a substance use disorder or nicotine dependence will be able to sign up for technology-supported care at home through Medicare’s ACCESS Model. The Centers for Medicare & Medicaid Services announced the expansion on September 15, 2026. Participating organizations may offer virtual visits, health coaching, remote monitoring and connected devices between regular doctor appointments, and CMS will pay them based on whether patients’ health measurably improves.
Four new conditions join the program in spring 2027
According to the CMS announcement, the new tracks will cover:
- Heart failure: continuous monitoring aimed at measurable gains in function, symptom management and quality of life.
- COPD: targeted support to help maintain or improve lung function, ease symptoms and support daily activities.
- Substance use disorders: care for opioid, alcohol and other substance use disorders, including support for co-occurring depression and anxiety.
- Tobacco cessation: help for people trying to quit.
CMS is also extending support for chronic musculoskeletal pain beyond the initial 12-month care period for certain conditions. The agency’s ACCESS model page lists April 1, 2027 as the start date for all of the new tracks, and organizations already in the model or with applications pending will not need to reapply to offer them.
“We built ACCESS because too many people with chronic conditions were falling through the cracks between appointments,” said CMS Administrator Dr. Mehmet Oz. He said the expansion would give patients and providers more access to remote monitoring, connected devices and AI-enabled tools that can help catch problems earlier.
For managing a chronic condition on a fixed income. Heart failure and COPD often come with several daily prescriptions, and home monitoring does not change what those drugs cost at the pharmacy. The medication and cost tracker and the new Part D out-of-pocket cap are covered in The Medicare Cost & Coverage Protection Kit.
How the ACCESS Model works
ACCESS, short for Advancing Chronic Care with Effective, Scalable Solutions, is a 10-year model run by the CMS Innovation Center that began July 5, 2026. It already covers high blood pressure, high cholesterol, obesity, prediabetes, diabetes, early chronic kidney disease, heart disease, chronic musculoskeletal pain, depression and anxiety. CMS says three out of four people with Medicare qualify for at least one track.
The model changes how Medicare pays for this type of care. Instead of paying for each visit or device, CMS makes recurring payments to participating organizations for managing a patient’s condition, with full payment tied to measurable results, such as lowering a patient’s blood pressure by a set amount from where it started. Rural patients in qualifying tracks carry a fixed payment adjustment meant to encourage organizations to serve areas with fewer local care options.
Payment is judged across an organization’s whole patient panel rather than patient by patient. CMS compares the share of patients who hit their outcome targets with a minimum threshold that rises each participation year. Most tracks include an initial year of care followed by an optional continuation period at a reduced payment rate, which lets patients keep receiving support after the first year. Durable medical equipment suppliers and laboratory suppliers cannot participate as ACCESS organizations.
Services can include clinician consultations, nutrition and exercise coaching, therapy and counseling, medication management, ordering diagnostic tests, and use of FDA-authorized devices. Care may be delivered in person, by video, asynchronously through apps, or through other technology. Participating organizations must enroll in Medicare Part B, follow state licensure and HIPAA rules, and name a physician clinical director responsible for oversight. CMS says it may terminate organizations that fail to meet quality, safety or outcome standards.
Who can enroll and what it costs
ACCESS is open only to people with Original Medicare. Medicare Advantage enrollees are not eligible, although CMS notes their plans may offer similar programs. Separately, major health payers representing 165 million Americans in Medicare Advantage, Medicaid and private insurance have pledged to adopt an outcomes-based payment structure aligned with ACCESS, and 18 clinical and patient societies have endorsed the effort.
Enrollment is voluntary. Patients sign up directly with a participating organization, either on their own or after a referral from their primary care doctor. CMS says joining does not change Medicare benefits, coverage or rights, and beneficiaries keep the freedom to see any Medicare provider. On cost, the agency’s FAQ says some ACCESS organizations may waive standard Medicare cost-sharing, which means out-of-pocket charges could vary by organization.
For retirees on fixed incomes, that detail is worth checking before enrolling. Asking a participating organization whether it charges the usual Part B coinsurance,, can prevent surprise bills later. Primary care doctors also receive electronic progress updates from ACCESS organizations and may bill Medicare for reviewing them, so patients should expect their regular physician to stay involved.
Finding a participating organization
CMS says 160 organizations are participating at launch and more will be added over the model’s 10 years. The agency keeps a directory at Medicare.gov/ACCESS listing participating organizations and the conditions each one treats. CMS also plans to publish risk-adjusted health outcomes for each organization, giving patients and their doctors a way to compare results.
People with questions can call 1-800-MEDICARE. Because the new heart failure, COPD, substance use and tobacco tracks do not open until April 2027, anyone interested now can use the directory to see which organizations already serve their area under the existing tracks and ask whether they plan to add the new conditions.
Medicare’s fall open enrollment period, which runs from October 15 through December 7, is also relevant. Because ACCESS is limited to Original Medicare, someone with heart failure or COPD who is weighing a switch between Original Medicare and Medicare Advantage for 2027 may want to factor the new tracks into that decision alongside premiums, drug coverage and provider networks.
New care options arrive alongside a busy open enrollment season
A home-monitoring program can help manage heart failure or COPD, but the bigger money decisions this fall involve drug plans, coverage denials and state assistance that ACCESS does not address.
The Medicare Cost & Coverage Protection Kit includes 51 state Medicare cost-help packs and the prior-authorization appeal steps, along with a medication and cost tracker for recording each prescription and charge.
Review coverage options with The Medicare Cost & Coverage Protection Kit.
This article was prepared with AI assistance and reviewed against the linked official sources.
