Learn More About Medicare ACOs
Coordinating care across multiple providers can improve your treatment and health outcomes. Coordinated care can help reduce unnecessary duplicate services, prevent medical errors, and make sure your providers have the information they need to deliver more effective care.
Medicare’s coordinated care programs include Accountable Care Organizations (ACOs) and ACO Realizing Equity, Access, and Community Health (ACO REACH).
If your doctor or other provider is part of an ACO, you still have the right to visit any doctor, hospital, or other provider that accepts Medicare at any time.
Accountable Care Organizations
An Accountable Care Organization (ACO) is a group of doctors, hospitals, and other health care providers who accept Original Medicare and work together to coordinate your health care.
- You receive patient-centered care focused on your needs.
- Your providers can view the same test results, treatments, and prescriptions.
- Better coordination can help prevent medical errors and drug interactions.
- You save time, money and frustration by avoiding repeated tests and appointments.
- Improved communication can help reduce Medicare fraud and waste.
ACO providers work together and may use shared health records to coordinate care more efficiently, which can reduce repeated testing and save time on paperwork.
Additional ACO Benefits
If your primary care provider participates in an ACO, you may have access to additional benefits. In some cases, this may include expanded telehealth services, allowing certain types of care to be provided from home using a phone or computer.
Some ACO participants may also be able to refer eligible patients for skilled nursing facility or rehabilitation care without the usual 3-day hospital stay requirement, when Medicare rules allow it.
If your primary care provider participates in an ACO and you have Original Medicare, you may receive a written notice and see a poster in the office about the practice’s ACO participation.
How ACOs Share Information
One of the key benefits of an ACO is that your doctors and other providers can communicate and coordinate your care more effectively. Medicare may allow your provider’s ACO to request certain information about your care so the people involved in your treatment have access to the information they need.
Medicare protects the privacy of your health information. If you do not want Medicare to share your information with your health care providers for care coordination, you may opt out by calling Medicare. Medicare may still share general information to measure provider quality.
ACO Realizing Equity, Access, and Community Health Model
The ACO REACH model helps primary care and specialty providers work together to improve quality of care and health outcomes for people with Original Medicare. This model also supports better care delivery and coordination for people in underserved communities.
How does it work?
If your doctor participates in this model, you may receive a letter explaining that your provider is working with an Accountable Care Organization to enhance your care through the ACO REACH Model.
What does it mean for my care?
You still have the same coverage, benefits, and rights you receive through Original Medicare, including:
- Freedom to visit any Medicare provider
- The option to switch health care providers at any time
You may also have access to extra benefits in some programs, such as telehealth visits, home care after leaving the hospital, and help with certain out-of-pocket costs.
Are my Medicare rights & benefits protected?
Yes. You still:
- Can get care from any provider that accepts Medicare
- Have access to all of your current Medicare benefits
- Can switch health care providers at any time
