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Frequently Asked Questions (FAQ) about Accountable Care Organizations

Q: What is a Medicare ACO?

A: ACOs, or Accountable Care Organizations, bring together groups of healthcare providers, including doctors, hospitals, and other healthcare professionals to work together by forming partnerships to provide coordinated and high-quality care to patients. An ACO isn’t the same as a Medicare Advantage Plan or Health Maintenance Organization (HMO). You’re still in Original Medicare, and your Medicare benefits, services, rights, and protections won’t change.

Q: How does an ACO help me?

A: Your healthcare provider coordinates with other providers to ensure that you receive consistent, high-quality care. You may also receive help scheduling appointments, arranging services related to your health, and follow-up calls from a member of your healthcare provider’s team. Enhanced communication between healthcare providers means you won’t have unnecessary tests, procedures, or medications, reducing the risk of medical errors and saving you time and money. Additionally, there is a strong focus on high-quality preventative care, which means you are less likely to need emergency care or hospitalization.

Q: Do I have to pay extra for services provided by a Medicare ACO?

A: No, you do not have to pay extra for services provided by a Medicare ACO. You’re still in Original Medicare and your Medicare benefits, services, rights and protections won’t change. This is a way for your provider to offer you extra support at no additional cost.

Q: How do I know if I am part of a Medicare ACO?

A: If your healthcare provided decides to participate in an ACO, you should receive a notification from your healthcare provider or their ACO that informs you that your healthcare provider is participating in an ACO. Your healthcare provider should also have information about the ACO displayed in their office.

Q: Do I have to see a specific doctor or healthcare provider in a Medicare ACO?

A: No, you can continue to see the same doctors and healthcare providers that you currently see. Your providers may work more closely together to ensure that you receive coordinated care.

Q: Can I opt out of a Medicare ACO?

A: You are in an ACO because your healthcare provider chose to participate in an ACO. You can only opt out of the ACO by choosing a healthcare provider who is not participating in an ACO. However, you can tell Medicare not to share your healthcare information by contacting Medicare at 1-800-MEDICARE (633-4227).

Q: Will my privacy be protected if I am part of a Medicare ACO?

A: Yes, your privacy will be protected if you are part of a Medicare ACO. ACOs are required to comply with all applicable privacy laws and regulations.

Q: Can I still see healthcare providers outside of the Medicare ACO?

A: Yes, you can still see healthcare providers outside of the Medicare ACO. However, it’s important to let your ACO providers know about any care you receive outside of the ACO to ensure that your care is coordinated.

Q: Where can I find more information about ACOs?