What’s An Accountable Care Organization (ACO)?
- ACOs are groups of doctors and other health care providers who voluntarily work together with Medicare to give you high quality service and care at the right time in the right setting.
- An ACO is not a Medicare Advantage Plan, (like an HMO or PPO), or an insurance plan.
- ACOs don’t change your Medicare benefits.
How Will An ACO Help My Doctor Coordinate My Care?
- Your doctors will have a more complete picture of your health through talking with your other doctors.
- To help you get better, more coordinated care, Medicare will share certain health information with us about the care you get from your doctors and other health care providers unless you ask Medicare not to share it.
- West Michigan Family Health, PC may continue to recommend that you see particular doctors for your specific health needs, but it’s always your choice about what doctors you see or hospitals you visit.
What Do I Need To Do?
- If you want Medicare to share information about care you’ve received with us, there’s nothing more you need to do.
- If you do not want Medicare to share your health care information with POM ACO, call 1-800 MEDICARE (1-800-633-4227) and tell the representative that your doctor is part of an ACO and you don’t want Medicare to share your health care information. TTY users should call 1-877-486-2048.
- If you do not call 1-800-Medicare and request not to share your health care information, it will be shared with your ACO and with other ACOs in which any of your doctors or other healthcare providers participate for the purposes of care coordination and quality improvement.
- If you change your mind in the future, call 1-800-MEDICARE and tell the representative what you have decided.
- Even if you decline to share your health care information, Medicare will still use your information for some purposes, including certain financial calculations and determining the quality of care given by your health care providers participating in ACOs. Also, Medicare may share some of your health care information with the ACOs when measuring the quality of care given by healthcare providers participating in the ACOs.
If you have questions or concerns, you can talk with your doctor at West Michigan Family Health, PC, at any time, and you can request more information about the Medicare Shared Savings Program and how to decline to share your health information with ACOs. You can also visit www.medicare.gov/acos.html or call 1-800-MEDICARE (TTY users should call 1-877-486-2048).