Medicare is expanding its pilot program that funds wearable and digital technologies designed to support the management of chronic conditions, as part of an ongoing effort to reduce healthcare costs and improve patient outcomes. The program, known as the ACCESS model, initially launched in July and has begun to include additional chronic conditions in its scope.
ACCESS, which stands for Advancing Chronic Care with Effective, Scalable Solutions, was introduced last year as a decade-long experiment by the Medicare Innovation Center. It pays participating companies based on patient health outcomes rather than service volume, encouraging the use of technology to help patients manage conditions such as diabetes, high blood pressure, chronic musculoskeletal pain, and depression.
On Tuesday, Medicare officials announced the expansion of eligible conditions to include substance use disorder, heart failure, chronic obstructive pulmonary disease (COPD), and extended support for musculoskeletal conditions. These new condition categories are slated to begin participation in the spring of 2027. That same day, Medicare published for the first time a directory of approved health care providers authorized to enroll patients under the ACCESS model; so far, 39 organizations have been accepted.
ACCESS is rooted in the Trump administration’s broader push to boost digital health adoption as a means to lower costs. The model sets relatively low payment amounts for providers, intending to incentivize innovation that reduces dependence on traditional clinician-led care. Annual payments for enrolled companies range from a maximum of $180 per patient for behavioral health conditions to $420 for cardiovascular, kidney, or metabolic issues.
The program has attracted a variety of health technology firms, including Boston-based Whoop, known for wearable devices; Alivecor, specializing in heart health monitoring; and Welldoc, a developer of diabetes management tools. Other participants employ artificial intelligence for patient triage and mental health support, such as Doctronic, Counsel Health, and Limbic. These entities represent a subset of more than 150 firms that had been provisionally accepted earlier this year.
However, some leading digital health providers targeting chronic disease, including Omada, Sword Health, and Hinge Health, opted not to join ACCESS. Citing insufficient payment rates to sustain their clinician-intensive service models, these companies have raised concerns about the financial viability of participating.
Additionally, there are apprehensions about potential care fragmentation, as patients might receive parallel management from ACCESS providers without seamless communication with their primary care physicians. To address this, the program requires ACCESS providers to make efforts to coordinate with patients’ existing primary care clinicians and offers modest additional payments for such coordination.
Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz highlighted the program’s potential role in improving healthcare affordability, noting during a Tuesday event that artificial intelligence could contribute to cost reductions and better outcomes. The expansion of ACCESS reflects Medicare’s continued interest in leveraging technology-driven approaches to chronic care management amid growing demand and healthcare spending pressures.