How Would I Know If My Doctor Participates In An Accountable Care Organization (ACO)?

If your doctor chooses to participate in an ACO, you will be notified. 

Or, ask your doctor or healthcare provider if he or she is participating in a Medicare ACO. For general information on ACOs, call 1-800-MEDICARE (1-800-633-4227) 24 hours a day/7 days a week. TTY users should call 1-877-486-2048.

What Can I Expect If My Doctor Is In An ACO?

Over time, if you see a doctor participating in an ACO you may notice that:

  • You don't have to fill out as many medical forms that ask for the same information
  • The healthcare providers that you see all know what is going on with your health because they communicate with each other
  • You don't have to have the same medical tests done over and over because your results are shared among your health care team
  • The providers participating in the ACO will become partners with you in making care decisions

Here are some of the things that WON'T change because your doctor is part of an ACO:

  • What you pay, your Medicare benefits, or the cost of your coverage should not increase.
  • Your right to choose any hospital or doctor that accepts Medicare, at anytime, will not change even if that hospital is not part of an ACO.
  • Some ACOs may hire people to help check on your care. They may call you after an appointment or a procedure to make sure you understand how to take your medicines or to schedule follow-up visits. They will also share information with your doctor to make sure you get the right care.

What Rights Do I Have If My Doctor Is In An ACO?

You will continue to receive the same rights enjoyed by all people with Medicare. To help you get the best-coordinated care, Medicare will share information about your medical background with your doctor's ACO, including medical conditions, prescriptions, and visits to the doctor. This is important to help the ACO keep up with your medical needs and track how well the ACO is doing to keep you healthy and helping you get the right care.

Your privacy is very important to us so you may choose to have your name and other personal information removed from the information that Medicare shares with your doctor by doing one of the following:

  • Calling 1-800-MEDICARE (TTY users should call 1-877-486-2048)

If you receive a letter from your doctor, unless you take one of the steps listed above, your medical information will be shared automatically commencing 30 days from the date you are notified.

Medicare won't share information about anyone who has ever received treatment for alcohol or substance abuse without written permission.

Beginning in 2013, Medicare will also be following up with people with Medicare to ask about your experiences as a patient of a doctor who is participating in a Medicare ACO. As time gets closer, you will get a letter to let you know the survey is genuine. Medicare will use your feedback to help make certain you are receiving high quality care.

Who Will Read My Medical Information? Will It Be Protected?

The group of doctors, hospitals, and other health care providers together in the ACO will be able to read your medical records, along with other staff authorized to help coordinate your care.

The privacy and security of your medical information is protected by Federal law. Contact your doctor's office for more information about how they protect your medical information, or call 1-800-MEDICARE (1-800-633-4227) 24 hours a day/7days a week. TTY users should call 1-877-486-2048.

How Will An ACO Lead to Better Care For Me?

When your health care providers have access to your health information and are better able to share that information with one another, they can give you better, more coordinated care. Each of your health care providers will not only know about the health issues that they have treated, they will have a more complete picture of your health through communicating with your other health care providers.

If your health care providers are participating in an ACO, over time, you should see better coordinated health care where you are the center of care and your satisfaction is a goal of the ACO.

Where Can I Find Additional Information About ACOs?

For additional information about ACOs, you can do the following:

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