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Frequently asked questions, about ACO, answered for you
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In an Accountable Care Organization (ACO), doctors, hospitals, and other health care providers work together to provide better, more coordinated health care. The Accountable Care Organization improves the coordination of your care and creates improved access to critical information. This helps your physicians provide you with optimal, high quality care.
Doctors and hospitals work each day to provide you with high quality care, but it can be a challenge to juggle information from one physician or hospital to another. That’s why the Accountable Care Organization (ACO) concept was created by Medicare.
You’ll benefit from this ACO because the Deaconess doctors and hospitals you know and trust will be part of a better team. They will work more closely together than ever before to get you the right care at the right time in the right setting.
Doctors and hospitals in an ACO communicate with you and with each other to make sure that you get the care you need when you are sick, and the support you need to stay healthy and well.
Because of EPIC, the Deaconess electronic medical records system (EMR), Deaconess has already seen measurable improvements in quality and continuity of care. By creating this ACO, our patients can look forward to even greater improvements, leading to more convenience and better care.
Absolutely—if your doctor participates in an ACO, you can see any healthcare provider who accepts Medicare. Nobody—not your doctor, not your hospital—can tell you who you have to see or where you can receive care. We may continue to recommend that you see particular doctors for your specific health needs, but it’s always your choice about which doctors your see or which hospitals you visit.
No. An ACO is a group of doctors, hospitals, and other health care providers who work together to provide you with better, more coordinated care. In this case, the Deaconess ACO includes Deaconess Hospital (including both main and Gateway facilities) Deaconess Clinic, The Heart Hospital and doctors/other providers employed by one of these facilities
An ACO isn’t an HMO, insurance company, or managed care or Medicare Advantage plan. Unlike HMOs, managed care, or some insurance plans, an ACO can’t tell you which health care providers to see and can’t change your Medicare benefits. If your doctor participates in a Medicare ACO, you always have the right to choose any doctor or hospital who accepts Medicare at any time.
If your doctor chooses to participate in an ACO, you will be notified. This notification might be a letter, written information provided to you when you see your doctor, a posted sign, or it might be a conversation with your doctor the next time you go to see him or her. Deaconess Medicare Fee-for-Service beneficiaries are sent a letter notifying them of the Deaconess ACO.
Deaconess Care Integration has signs posted in care settings indicating our participation in the Medicare Shared Savings Program, and we will answer any of your questions at your next visit or over the phone.
If you aren’t sure if your doctor or healthcare provider is participating in a Medicare ACO, ask him or her. 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.
Over time, if you see a doctor participating in an ACO, you may notice that:
Here are things that won’t change because your doctor is part of an ACO:
- You don’t have to fill out as many medical forms that ask for the same information;
- The health care 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.
- 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 any time, will not change even if that hospital or doctor is not part of an ACO.
Another benefit of an ACO is that your Deaconess doctor’s office or hospital may have specially-dedicated staff checking on you after you’ve received care. They may call you after an appointment or a procedure to make sure you understand how to take your medicines or schedule follow-up visits. They will also share information with your doctor to make sure you get the right care.
You will continue to receive the same rights enjoyed by all people with Medicare Fee-for-Service. To help you to get the best-coordinated care, Medicare will share information about your medical information with the Deaconess ACO, including medical conditions, prescriptions, and visits to the doctor. Having this information will help your primary care physician and other health care providers give you high-quality care, because we will have the most up-to-date information about your health.
If you receive a letter from your doctor, your medical information will be shared automatically starting 30 days from the date you are notified. Medicare began sharing information with the Deaconess ACO on September 1, 2012.
Medicare won’t share information about anyone who has ever received treatment for alcohol or substance abuse without written permission. If you have received drug treatment and want Medicare to share that information with your doctor’s Medicare ACO complete the “Alcohol or Substance Abuse Medical Data Sharing Form” and mail it in or contact 1-800-MEDICARE (1-800-633-4227).
Starting in 2013, Medicare will also be following up with people with Medicare Fee-for-Service 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 sure you get high quality care.
The group of Deaconess doctors, hospitals, and other health care providers working together in the ACO will be able to read your medical records, along with other office 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/7 days a week. TTY users should call 1-877-486-2048.
If you want to ask Medicare not to share your information with the Deaconess ACO, you should take one of these steps:
- Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
- Complete and sign the “Declining to Share Personal Health Information” form in your primary care doctor’s office.
Even after Medicare begins to share your information with us, you may always ask Medicare to stop sharing information in the future.
When your health care providers have access to your health information and are able to share that information with one another, they can give you better, more coordinated care that meets your unique individual needs and preferences. Each of your Deaconess 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.
Because your Deaconess health care providers are participating in an ACO, over time, you should see better more coordinated health care--where you are the center of care. Your satisfaction is a goal of the ACO.
If you have questions or concerns, you can call your Deaconess primary care physician office, or bring it up the next time you’re in your doctor’s office.
For more information about ACOs overall, you can do the following:
Content includes information from CMS Product No. 11588 October 2011
- Visit www.cms.gov/ACO/.
- Visit www.Medicare.gov/ACO.
- Talk to your doctor.
- Call 1-800-MEDICARE (1-800-633-4227) 24 hours a day/7 days a week. TTY users should call 1-877-486-2048.