A new CMS Innovation Center model called ACCESS is now giving some Original Medicare beneficiaries with chronic conditions access to virtual visits, wearable devices and lifestyle coaching, coordinated through a participating organization rather than added to every Medicare card automatically. The name stands for Advancing Chronic Care with Effective, Scalable Solutions, a full title that appears on CMS’s own program page rather than in the shorthand Medicare’s beneficiary-facing fact sheet uses. Because the model runs through a test-and-scale structure, it reaches only beneficiaries whose chronic conditions match one of its tracks and whose doctor or a partnering organization has already signed on.
ACCESS models chronic care as five tracks, not one open-ended benefit
Medicare’s 2027 fact sheet frames the model in plain terms for beneficiaries, describing at-home chronic care support that includes virtual visits, wearable devices, lifestyle coaching “and more” at low or no cost, coordinated with a beneficiary’s existing doctor. That beneficiary-facing description leaves out both the model’s formal structure and its timeline, details that only appear on CMS’s own program page.
CMS’s ACCESS model page states the model began July 5, 2026 and runs for 10 years, organized around condition-specific tracks rather than a single blanket chronic-care benefit. The initial tracks cover early cardio-kidney-metabolic conditions, more advanced cardio-kidney-metabolic conditions, musculoskeletal pain, and behavioral health conditions including depression and anxiety, with a further set of tracks for heart failure, COPD, substance use disorder and tobacco cessation scheduled to launch April 1, 2027.
The ACCESS model page also fills in what the covered support technically includes beyond the fact sheet’s shorthand: clinician consultations, lifestyle and behavioral support covering nutrition, exercise and smoking cessation, patient education, therapy, counseling, medication management, and diagnostic testing using FDA-cleared hardware and software devices, all organized under the five condition tracks rather than offered as a single undifferentiated benefit.
Inside the coverage kit: A new model with five separate condition tracks and a January cap on out-of-pocket drug costs both land on the same Medicare calendar year, so a medication and cost tracker alongside the kit’s annual cost review gives one place to log how a chronic-care service interacts with everything else Medicare already covers. Track chronic-care services alongside drug costs in The Medicare Cost & Coverage Protection Kit.
Payment follows outcomes, not the number of visits billed
CMS Innovation Center director Abe Sutton and chief AI and technology officer Jacob Shiff described the model’s payment structure, called Outcome-Aligned Payments, in a CMS Innovation Center blog post announcing the expansion, writing that the approach “rewards health outcomes rather than required activities.” That marks a departure from Medicare’s typical fee-for-service structure, where a provider bills for each individual visit or service delivered regardless of whether a patient’s underlying condition improves.
The same blog post states that care delivered through ACCESS “can be in person, virtually, or asynchronous, whatever meets patients’ needs,” giving participating organizations flexibility in how they combine the model’s wearable-device monitoring, coaching and clinician consultations for an individual beneficiary rather than requiring a fixed visit schedule. That flexibility is built into the outcome-based payment structure itself, since a participating organization is not paid strictly per encounter the way a traditional Medicare provider is.
Outcome-Aligned Payments is a departure CMS has tested in narrower forms before, but ACCESS applies it across five separate chronic-condition tracks at once rather than to a single disease category, making it one of the broader outcome-based models the Innovation Center has run for Original Medicare beneficiaries specifically, as opposed to Medicare Advantage plans that already build similar incentives into their own contracts with CMS.
The model reaches beneficiaries through participating organizations, not automatically
Access to ACCESS depends on a beneficiary’s chronic condition matching one of the model’s tracks and on a participating organization operating in that beneficiary’s area, a structure common to CMS Innovation Center models but different from a standard Medicare benefit that applies nationwide the moment it takes effect. The four tracks launching April 1, 2027 expand the conditions covered beyond the original cardio-kidney-metabolic, musculoskeletal and behavioral health tracks that began with the July 2026 start date, but CMS’s page does not describe every region as having a participating organization for every track.
That geographic and diagnostic gating separates ACCESS from Medicare benefits that apply the moment a beneficiary enrolls, such as annual wellness visits or preventive screenings covered nationwide under Original Medicare’s standard benefit structure. A beneficiary with a qualifying chronic condition whose doctor has not joined a participating organization, or who lives in a county where no organization has signed on for that condition’s track, does not gain access to ACCESS simply by asking, since the model operates through the organizations CMS has approved rather than through direct beneficiary enrollment.
Because the model runs for 10 years rather than as a permanent Medicare benefit, its long-term availability past that decade-long test period depends on the outcomes CMS is able to measure against the Outcome-Aligned Payments structure Sutton and Shiff described, the same standard CMS uses to decide whether an Innovation Center model eventually expands into permanent Medicare policy or winds down when its test period ends. A beneficiary whose doctor already partners with a participating organization gains access to wearable-device monitoring and coaching without a separate enrollment fee, according to Medicare’s 2027 fact sheet, but the model’s track-based design means eligibility still turns on both a qualifying diagnosis and geography rather than on Original Medicare enrollment alone.
A new model does not reach every ZIP code or every diagnosis
ACCESS covers five tracks of chronic conditions through participating organizations, not every Original Medicare beneficiary managing a chronic illness, and CMS has not published a full list of which organizations are participating in which regions.
The Medicare Cost & Coverage Protection Kit includes 51 state Medicare cost-help packs and a medication and cost tracker, built for finding what help exists locally and logging ongoing costs when a new model like ACCESS is not available in a given area.
See the state-by-state resources in The Medicare Cost & Coverage Protection Kit.
This article was researched and drafted with the assistance of AI and reviewed by The Money Overview editorial team.
