OhioHealth Medicare Accountable Care Organization (ACO)

A Medicare ACO is a network of doctors and other healthcare providers who voluntarily work together to provide Medicare Fee-for-Service beneficiaries the most coordinated, efficient, high-quality care.

The goal of the ACO is to support your doctor in caring for you by making sure they have the most up-to-date information about your health and your care. For you, this means your doctors communicate better with each other, and you avoid having duplicate tests or answering the same questions over and over. Working together, your doctors can do more to follow your health, ensuring you get the best possible care.

Doctors and other healthcare providers choose to participate in an ACO because they’re committed to providing you with a better care experience.

In fact, Medicare ACOs are evaluated 31 quality measures in four categories: Patient Experience, Care Coordination and Patient Safety, Preventive Health, and Caring for At-Risk Populations. The doctors may also be financially rewarded for offering you better, more coordinated care.

An ACO isn’t 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. And you still have the right to use any doctor or hospital that accepts Medicare at any time, the same way you do now.

If your doctor is participating in an ACO, you will see a poster with information about your doctor’s participation displayed in the office or hospital.

Only your doctor participates in an Accountable Care Organization. As the patient, you do not participate and you have the right to see any doctor or hospital that accepts Medicare, at any time. 

Yes, that doesn’t change. You can still go to any doctor, hospital or other healthcare provider that accepts Medicare, and you are still entitled to all the same Medicare services, benefits and protections.

To help your doctors who participate in the ACO provide you efficient, high-quality care, Medicare wants to share information about your care with the ACO. This includes information about visits to your doctor, hospitals, and pharmacies in the past and moving forward. This information helps the ACO track the services you’ve already received, understand where you may need more care, and to ensure a seamless experience should you have to transfer in or out of a hospital, or from the care of one doctor to another. If you do not want Medicare to share your health care information with the ACO, you can call 1-800-MEDICARE (633.4227). TTY users should call 1 (877) 486.2048. 

Simply call 1-800-MEDICARE (633.4227). TTY users should call 1 (877) 486.2048. Tell the operator you’re calling about ACOs and you don’t want to share your health care information with an ACO.

After your talk with someone at 1-800 MEDICARE, Medicare will update its records to show that you don’t want to share your health care information. If you call 1-800 Medicare, you’ll get a letter confirming this change. It’ll take about 45 days for this change to take effect.

Participating in an ACO allows your doctor greater access to expertise, staff, and technologies that ensure your care is coordinated across all the places you receive care. This coordination could mean less paperwork to fill out at the doctor’s office and avoiding unnecessary tests.