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November 4, 2026

Takeaways from the most recent news in the technology and policies shaping healthcare.

Government

CMS Expands ACCESS Model to Four New Chronic Conditions

By Healthcare Technology News ·

CMS is widening the reach of its ACCESS Model, an outcomes-based payment program that launched in July with 160 participating providers. Starting in spring 2027, the model will add four new chronic conditions: heart failure, COPD, substance use disorders and tobacco cessation, according to MedCity News.

The expansion changes the scale of the program. Once the new tracks go live, roughly three in four Medicare beneficiaries will be eligible for at least one, turning ACCESS from a targeted pilot into a broad test of paying providers based on patient outcomes rather than volume of services.

For providers, the additions cover some of the most common and costly conditions in the Medicare population. Heart failure and COPD drive frequent hospitalizations, while substance use and tobacco use are major upstream cost drivers. The move signals CMS's continued push toward value-based arrangements and gives participating organizations more room to build outcome-focused care around chronic disease management.

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More in Government

Government

Georgia's Medicaid Work Rules Near Expiration as US Scales Up

Georgia's Pathways to Coverage, the only live Medicaid work requirement program, may expire just as federal rules modeled on it expand nationwide.

Why it matters: Georgia's underperforming experiment is now the template for a national Medicaid policy affecting millions of enrollees.

Government

Valadao Backed Medicaid Work Rules His Own Voters May Dodge

Rep. David Valadao voted for the GOP law imposing Medicaid work requirements, then told his heavily Medi-Cal-dependent California district many residents may be exempt.

Why it matters: The One Big Beautiful Bill's $900 billion in Medicaid cuts and new work rules will reshape coverage, and how exemptions are applied will determine who keeps insurance.

Government

CMS Finalizes Tougher Oversight of Organ Procurement Groups

CMS finalized a rule clarifying when it can decertify underperforming organ procurement organizations and letting top performers expand into more service areas.

Why it matters: Tighter accountability for organ procurement groups could reshape donation coverage and reduce the number of viable organs that go unrecovered.