How do ACOs work?
An ACO isn’t a Medicare Advantage plan which is an “all in one” alternative to
Original Medicare, offered by private companies approved by Medicare. An ACO isn’t
an HMO plan, or an insurance plan of any kind.
ACOs have agreements with Medicare to be financially accountable for the quality, cost, and experience
of care you receive.
Coordinated care can avoid wasted time and costs for repeated tests and unneeded appointments. It may
make it easier to spot potential problems before they become more serious – like drug interactions that
can happen if one doctor isn’t aware of what another has prescribed.
ACOs may use electronic health records, case managers, and electronic prescriptions to help you stay
healthy. Some ACOs have special programs to encourage you to have a primary care visit or use their
care management team. Participation in these programs is optional.
What information will be shared about me?
Medicare shares information about your care with your health care providers; like dates and times you
visited a health care provider, your medical conditions, and a list of past and current prescriptions. This
information helps _________________________________________________ track the care and tests
that you’ve already had.
Sharing your data helps make sure all the providers involved in your care have access to your health
information when and where they need it.
We value your privacy. ACOs must put important safeguards in place to make sure all your health care
information is safe. We respect your choice on how your health care information is used for care
coordination and quality improvement. If you want Medicare to share your health care information with
______________________________________________________ or other ACOs in which your health
care providers participate, there’s nothing more you need to do.
Medicare Shared Savings Program
Accountable Care Organizations
_________________________________________________ participating in
_________________________________________________, an Accountable Care
Organization (ACO). An ACO is a group of doctors, hospitals, and/or other health care
providers that work together to improve the quality and experience of care you receive. ACOs
receive a portion of any savings that result from reducing costs and meeting
quality requirements.
Medicare evaluates how well each ACO meets these goals every year. Those ACOs that do a good job can
earn a financial bonus. ACOs that earn a bonus may use the payment to invest more in your care or share a
portion directly with your providers. ACOs may owe a penalty if their care increases costs.
_________ participation in _____________________________________________ doesn’t limit your choice
of health care providers. Your Medicare benefits are not changing. You still have the right to visit any doctor,
hospital, or other provider that accepts Medicare at any time, just like you do now.
To help us coordinate your health care better, Medicare shares information about your care with your
providers. If you don’t want Medicare to share your health care information, call 1-800-MEDICARE
(1-800-633-4227).
Important!
