CMS Adds New Clinical Conditions to ACCESS Model to Expand Technology Enabled Chronic Care Management

Reimbursement; Skilled Nursing Facilities (SNF)
 

The Centers for Medicare and Medicaid Services (CMS) has announced several enhancements to the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model.  

Beginning April 1, 2027, CMS will add four new clinical tracks: 

  • Heart failure 
  • Chronic obstructive pulmonary disease (COPD) 
  • Substance use disorders; and  
  • Tobacco cessation.  

CMS will also add a follow-on track that provides extended support for certain chronic musculoskeletal conditions beyond the initial 12-month care period. In addition, CMS plans to add more organizations through its rolling application process over the next ten years.  

These updates broaden the reach of the ACCESS Model and may create additional opportunities for technology-enabled chronic care management for Medicare Fee-for-Service (FFS) beneficiaries. Long term care providers may find partnership opportunities with participating Medicare Part B providers and technology-enabled care organizations serving residents with these conditions. 

For a full overview of the ACCESS Model, including eligibility requirements, payment methodology, clinical tracks and participation details, read our previous blog here

CMS is currently accepting interest forms and has released a Request for Applications (RFA) with additional details. Rolling applications will continue through 2033. 

Model FAQs.  

Please reach out to AHCA’s Population Health Policy Analyst Rohini Achal or Nisha Hammel, Vice President, Reimbursement Policy & Population Health with any questions.