CMS just announced a major expansion of the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model. Physician groups that understand the payment structure stand to benefit significantly.

Starting in Spring 2027, ACCESS will add new condition tracks for heart failure, COPD, substance use disorders (including opioid and alcohol use disorders), and tobacco cessation. These join the model's existing tracks for hypertension, diabetes, chronic musculoskeletal pain, and depression. CMS estimates that three out of four Original Medicare beneficiaries qualify for at least one ACCESS track.

ACCESS represents a fundamentally different payment approach. Rather than paying per service, CMS ties payments directly to measurable improvements in patient health outcomes. Participating organizations can deliver virtual care, health coaching, remote monitoring, and connected devices between regular office visits, all reimbursed by Medicare outcomes-based framework.

Why Physician Groups Should Pay Attention

The business case here is straightforward. ACCESS is voluntary, but the model creates several revenue and referral pathways for physician groups:

• Primary care practices are positioned as the front door. ACCESS is designed so that primary care and other treating physicians refer eligible Medicare beneficiaries to participating organizations that integrate with the patient's existing care team. Groups that become ACCESS participants (or build referral relationships with them) can extend their care delivery without adding overhead.
• Cardiology and pulmonology groups should take particular note. The new heart failure and COPD tracks create dedicated payment pathways for the kind of longitudinal chronic disease management these specialists already perform but have historically struggled to bill for between office visits.
• Behavioral health and addiction medicine practices gain a reimbursable framework for SUD treatment that includes integrated support for co-occurring depression and anxiety, filling a gap that has long limited access to sustained recovery support under fee-for-service Medicare.
• Multispecialty groups can leverage ACCESS across multiple condition tracks simultaneously, creating a scalable chronic care management program under a single model.

Importantly, 160 organizations are already participating, major health payers representing 165 million covered lives have pledged to adopt aligned outcomes-based payment structures, and 18 clinical societies have endorsed the approach. This signals that ACCESS is not a pilot; it is infrastructure CMS intends to scale over the model's 10-year horizon.

Key Compliance Considerations

Physician groups considering ACCESS participation should keep several structural features in mind:

1. The model applies only to Original Medicare beneficiaries; Medicare Advantage enrollees are excluded.
2. Participation is voluntary and does not change a beneficiary’s Medicare benefits, coverage, or provider choice.
3. CMS maintains a public directory of participants and covered conditions at https://www.medicare.gov/providers-services/coordinating-care/support-chronic-health-conditions-access.

Groups should also evaluate their digital health infrastructure because the model emphasizes AI-enabled tools, remote monitoring, connected devices, and wearables. Compliance programs should address the risks of outcomes-based payment, including documentation of measurable health improvements.

The Bottom Line

ACCESS is CMS' clearest signal yet that the future of Medicare chronic care payment is outcomes-based and technology-enabled. Physician groups that position themselves now, either as direct participants or as referring providers integrated into the ACCESS ecosystem, will be prepared to capture new revenue while delivering the kind of between-visit care their chronic disease patients need.