CMS broadened its ACCESS model, expanding the outcomes-based payment framework starting in spring 2027 to include heart failure, COPD, substance use disorders, and tobacco cessation. The model initially launched in July with 160 participating providers and is expected to make roughly three in four Medicare beneficiaries eligible for at least one track. The policy change can influence provider incentives around quality and cost for conditions that overlap with therapeutic areas where biotech developers already compete on outcomes data. By adding substance use and tobacco cessation, CMS also ties reimbursement strategy more directly to interventions that may span pharmacologic and supportive care. For stakeholders, the key operational shift is that more providers will face track-based outcomes expectations across additional chronic and behavioral health conditions, potentially reshaping real-world evidence priorities.