Technology-supported care is set to reach more Medicare beneficiaries as the Centers for Medicare & Medicaid Services expands its ACCESS Model to additional chronic conditions in 2027. Beginning April 1, CMS will add care tracks for heart failure, chronic obstructive pulmonary disease, substance use disorder and tobacco cessation. The expansion is designed to give people with Original Medicare more ways to manage chronic conditions from home through services such as remote monitoring, virtual care, coaching, medication management and connected health technology.
The move builds on a model that began July 5, 2026 and is intended to run for 10 years through June 2036.
Technology-Supported Care Expands ACCESS Model
ACCESS stands for Advancing Chronic Care with Effective, Scalable Solutions.
The voluntary CMS Innovation Center model was created to address a persistent Medicare problem: traditional fee-for-service payment does not always fit technology-enabled care models that provide ongoing support between conventional office visits.
ACCESS currently includes conditions such as hypertension, diabetes, chronic kidney disease, cardiovascular disease, chronic musculoskeletal pain, depression and anxiety.
CMS says the existing tracks already apply to conditions affecting more than two-thirds of people with Medicare. Medical Buyer reports that three out of four Medicare beneficiaries qualify for at least one ACCESS track.
Technology-Supported Care Adds Four Areas
The 2027 expansion broadens the model considerably.
For heart failure, CMS plans to support continuous management aimed at improving symptoms, functional status and quality of life.
For COPD, technology-supported services may help patients manage symptoms and maintain or improve daily function.
The substance use disorder track will include treatment for opioid, alcohol and other substance use disorders, while also supporting co-occurring behavioral health needs such as depression and anxiety.
The tobacco cessation track will focus on helping Medicare beneficiaries stop tobacco use.
These additional tracks are scheduled to begin April 1, 2027.
CMS Pays for Outcomes Instead of Activity
One of the most significant features of ACCESS is its payment structure.
Traditional Medicare fee-for-service reimbursement generally pays healthcare providers for specific visits, procedures or services.
ACCESS introduces Outcome-Aligned Payments, or OAPs.
Participating organizations receive recurring payments for managing qualifying chronic conditions, but full payment depends on achieving measurable health outcomes.
For example, an organization treating hypertension could be evaluated on whether patients achieve clinically meaningful improvements in blood pressure.
Technology-Supported Care Gains Payment Flexibility
The outcome-based structure gives care organizations more freedom in how they support patients.
Rather than being paid only when a defined service occurs, participating organizations can use combinations of:
- Remote patient monitoring
- Wearable devices
- Telehealth
- Lifestyle coaching
- Behavioral support
- Medication management
- Patient education
- Care coordination
- Diagnostic testing and imaging
Care may be delivered in person, virtually, asynchronously or through other technology-enabled methods when clinically appropriate.
The objective is to reward actual health improvement rather than volume of activity.
Remote Care Could Help Rural Patients
Technology-supported chronic care may be especially valuable for patients who have difficulty accessing healthcare locally.
CMS specifically notes that digital care can help people in communities with limited local options, including rural areas.
A patient with heart failure, for example, may benefit from home monitoring and frequent clinical follow-up without traveling repeatedly to a hospital or specialist office.
Similarly, people with COPD or diabetes may use connected devices and ongoing coaching to identify changes earlier and manage their conditions between appointments.
This does not eliminate the need for in-person medical care.
Instead, ACCESS is designed to complement existing physicians and care teams.
Primary Care Remains Part of the Model
Primary care clinicians can refer patients to participating ACCESS organizations and receive structured updates about their progress.
CMS is also creating a co-management payment for clinicians who document review and coordination activities with ACCESS participants.
That structure is intended to prevent technology-supported care from becoming a disconnected layer outside the patient’s normal healthcare team.
Medicare beneficiaries also retain their existing rights and can continue seeing any Medicare provider.
Participation is voluntary and does not replace standard Medicare coverage.
More Than 160 Organizations Participate
CMS reported in September that more than 160 healthcare organizations are participating in ACCESS.
Many have not historically served Medicare beneficiaries, meaning the model is bringing new technology-enabled providers into Original Medicare.
Participants are required to enroll in Medicare Part B and comply with applicable licensing, privacy, security and quality requirements.
Organizations must also designate physician clinical leadership responsible for oversight and compliance.
CMS can remove participants that fail to meet safety, quality or outcome standards.
Private Payers Are Also Aligning
ACCESS could influence healthcare beyond Original Medicare.
CMS says private payers representing approximately 165 million members across Medicare Advantage, Medicaid and commercial insurance have committed to aligning with the model’s payment approach, with some beginning alignment in 2026.
That alignment is significant because digital health companies often face different reimbursement models across insurers.
A more consistent outcome-based payment framework could make it easier for technology-supported chronic care programs to scale across payer populations.
Technology-Supported Care Must Prove Results
The ACCESS Model also introduces stronger expectations around transparency.
CMS plans to publish risk-adjusted outcomes for participating organizations so patients and clinicians can compare performance.
That means digital health companies will ultimately need to demonstrate more than engagement, app downloads or device usage.
They will need to show measurable improvements in areas such as blood pressure, HbA1c, pain, mood, function or other condition-specific outcomes.
This could become an important shift for digital health.
Technology companies have often struggled to fit innovative care models into traditional Medicare payment structures. ACCESS creates a pathway, but ties that opportunity directly to clinical performance.
Medicare Digital Care Enters New Phase
The 2027 expansion signals that CMS increasingly views digital health as part of mainstream chronic disease management rather than a separate technology category.
By combining remote monitoring, virtual care, wearables and coaching with outcome-based reimbursement, ACCESS attempts to modernize how Medicare pays for care delivered outside traditional medical visits.
The success of technology-supported care will ultimately depend on whether these programs improve meaningful patient outcomes while controlling Medicare spending.
If ACCESS demonstrates that patients can manage chronic disease more effectively, remain independent longer and avoid preventable high-cost care, the model could influence how Medicare—and potentially other insurers—pay for digital healthcare well beyond the current 10-year test.
For more healthcare industry updates, insights and news, visit DistilINFO. Click here to subscribe to stay informed
