Accountable Care Organizations (ACOs) are groups of health care providers who come together voluntarily to give coordinated high-quality care to their Medicare patients. The goal of coordinated care is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. For patients, this means providers can do more to follow their health, make sure they get the best possible care, and may hire additional staff to help meet patients unique care needs.

Providers choose to participate in an Accountable Care Organization (ACO) because they are committed to providing patients with a better care experience. An ACO is not the same as a Medicare Advantage (MA) Plan or Health Maintenance Organization (HMO). Patients are still in Original Medicare, and their Medicare benefits, services, rights and protections won’t change. The continue still have the right to use any provider or hospital that accepts Medicare at any time.

Providers in Accountable Care Organizations (ACOs) may have better access to the expertise, staff, and technology they need to make sure care is coordinated across all the places patients receive services. This coordination could mean less paperwork to fill out at the provider’s office, avoiding unnecessary tests, or more help in dealing with any health conditions.

A listing of Health Choice Community Partner’s participating providers can be found on the following link: Insert Link. Patients can reach out to their provider’s office or contact Health Choice Community Partners directly at 305-471-8770 with any additional questions.

They don’t need to do anything. Even though a provider is participating in an ACO, a patients Medicare benefits will not change. They will still be in Original Medicare, and they will still have the right to use any provider or hospital that accepts Medicare, at any time.

Only the provider participates in an Accountable Care Organization (ACO). Patients do not participate in the ACO, they just receive the benefits.

Patients still have the right to see any provider or hospital that accepts Medicare, at any time. Patients can continue getting care from their provider or they can choose to see a provider that does not participate in an ACO.

Yes. It’s important to know that:

• Patients can still go to any provider, hospital, or other provider that accepts Medicare. Nobody can restrict which providers they see.

• Patients are still in Original Medicare.

• Patients are still entitled to all the same Medicare services, benefits, and protections.

To help providers who participate in an Accountable Care Organization (ACO) give patients the best possible care, Medicare wants to share some additional information about patients care with them. This information includes things like provider, hospital, and pharmacy visits in the past and moving forward. This information helps to make sure the provider knows about the services patients have already received, understand where they may need more care, and find ways to smooth the path for patients if they have to transfer in or out of a hospital, or from the care of one provider to another. If a patient decides they do not want to have their information shared with the ACO, they can elect not to.

It is important to note that Medicare will not share any information about a patient’s alcohol and drug treatment history unless they choose to share it and indicate that in writing.

Patients can prevent Medicare from sharing their information to the ACO at any time. They can call 1-800 MEDICARE (1-800-633-4227) and tell the operator they are calling about Accountable Care Organizations (ACOs) and would like to decline data sharing. TTY users should call 1-877-486-2048. Medicare will update its records to show that the patient does not want to have their data shared. It will take about 45 days for this change to take effect.

Yes. If the patient changes their mind in the future, they can call 1-800 Medicare (1-800-633-4227) and tell them that they have changed their mind and that they do want their data shared with the Accountable Care Organization (ACO).

An ACO is not a Medicare Advantage Plan, a health maintenance organization (HMO) plan or an insurance plan of any kind. It is an agreement between your health care provider and Medicare to be financially accountable for the quality, cost, and experience of care you received.