What is an Accountable Care Organization and what can it do for me?

Medicare has a new model where health care providers who share a common vision of improving patient care can work together more effectively by belonging to an Accountable Care Organization (ACO). Health care practices have voluntarily joined our ACO, HealthCare Partners ACO, as they believe it will help in providing better quality care for their patients. All of the health care providers participating in HealthCare Partners ACO have joined us in committing to patients’ needs and preferences, and to emphasize the coordination of their care. While you may feel as though your care is already coordinated, an ACO will act as a safeguard to ensure your care is always coordinated.

Doctors who work with ACOs find that they are able to give their patients better quality care. Medicare benefits do not change for beneficiaries whose doctors participate in an ACO. They may still go to any doctor, hospital, or other health care provider that accepts Medicare. But, because these doctors partner with HealthCare Partners ACO, they may be eligible to take part in some special programs, which will be provided at no additional cost.

In some instances, Medicare allows HealthCare Partners ACO to provide beneficiaries with a gift card for participation in a program that can help better manage diabetes, high blood pressure, heart failure, depression, or other health conditions. If your doctor participates in the HealthCare Partners ACO, ask if you are eligible for these programs.

Please click here to see a current list of participating providers in the HealthCare Partners ACO. Participants include primary care providers and specialists in: diabetes management, heart and lung disease, gastroenterology, neurology, orthopedic surgery, hospital medicine, and more. We also have partnerships with nursing and rehabilitation facilities as well as with local hospitals. Through our ACO, all of these providers are now linked, making it easier to coordinate and focus on patient care.

More about HealthCare Partners ACO

HealthCare Partners ACO offers beneficiaries access to a care coordination team that works with their doctor to meet their health care needs at no extra cost. The care coordination team may include: a care coordinator, nurse care manager, health educators, or specialized doctors including those who visit hospitals. This team can help by:

  • Calling beneficiaries who were in the hospital or emergency department to see how they are feeling and answer questions about medications, or to follow up with their doctor’s instructions.
  • Helping with referrals to specialists and scheduling appointments for preventative care services, such as mammography, colonoscopy, and immunizations.
  • Being available to help answer questions and provide information to manage health conditions at the ACO Care Management Team’s toll-free support phone line 1-855-414-1226.
  • Enrolling beneficiaries into health education and disease management classes to better coordinate their care to help them stay healthy, at no additional cost.

Questions?

If you have questions, please call HealthCare Partners ACO at 1-855-414-1226. Or, you may call Medicare at 1-800-MEDICARE (1-800-633-4227; TTY users may call 1-877-486-2048). You may learn more about Medicare accountable care organizations at https://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/ .