An ACO isn’t an HMO, managed care or insurance company. Unlike Health Maintenance Organizations (HMOs), managed care, or some insurance plans, an ACO can’t tell you which health care providers to see or change your Medicare benefits.
Medicare beneficiaries using the Morehouse Choice ACO-ES always have the freedom to choose doctors, hospitals, or other health care facilities and practitioners inside or outside of the Morehouse Choice ACO-ES. Medicare patients who see providers that are participating in the Morehouse Choice ACO-ES maintain all their Medicare rights, including the right to choose any doctor or other health care provider that accepts Medicare.
The Morehouse Choice ACO-ES does not interfere with your right to go where you choose for your healthcare services, but will help you navigate the health care system so that it’s not so confusing and time-consuming.
If your doctor chooses to participate in an ACO, you will be notified. This notification might be a letter, written information provided to you when you see your doctor, a sign posted in a hospital, or it might be a conversation with your doctor the next time you go to see him or her.
If you aren’t sure if your doctor or healthcare provider is participating in the Morehouse Choice ACO-ES or another Medicare ACO, ask him or her. For general information on ACOs, call 1-800-MEDICARE (1-800-633-4227) 24 hours a day 7/days a week. TTY users should call 1-877-486-2048. You can also
Visit http://www.cms.gov/ACO/.
Visit http://www.Medicare.gov/ACO.
Talk to your doctor.
Your primary care doctor is committed to providing quality medical care and maintaining certain standards of care.
Your doctor will focus on sick care, as well as, wellness and prevention, and other ways you can manage your health and lifestyle.
Collaborates with community-based healthcare providers, so you have access to more health center locations and services.
Helps to coordinate your care so you can avoid unnecessary tests and duplicative services.
The ACO-ES uses advanced health information systems.
For improved patient experiences, the Morehouse Choice ACO-ES has dramatically redesigned the way it delivers evidence-based healthcare through advanced Patient Centered Medical Homes. If you have a chronic illness, your physician will work with you to keep your condition under control.
If you’d like to benefit from this type of coordinated, quality care, please see our list of health center locations. CLICK HERE to view.
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.
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.
Your doctor 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.
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 Morehouse Choice ACO-ES, 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.
Your privacy is very important to us. However, If you have questions or concerns, you can talk with your doctor 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).
Your Care Team will include your personal doctor, and may include a registered nurse care coordinator, patient navigator, health educator, as well as other healthcare professionals like pharmacists, nutritionists, counselors, or specialists
It’s important for your provider to be able to assess and review your pertinent health information. Every doctor that you see should have access to your full medical record. Sharing health information amongst your providers is important for several reasons:
Identifying drug interactions and sensitivity of particular medications.
Reviewing medical tests for noting changes between tests and to help reduce costly duplicative services.
Medical privacy is maintained and your healthcare providers have access to your full medical record.
General public health information to help the medical community recognize trends, the beginning of a pandemic, and necessary public safety measures.
Electronic record keeping ensuring necessary tests are up to date when treating more serious conditions related to chronic disease.
The more that your providers know about your health the easier it is to diagnose and treat your illness.
You will have 24-hour access to your Patient Centered Medical Home (PCMH). If you have a health problem at any time day or night, weekday or weekend, your PCMH Care Team is available. We save you from the long waits and the help guide you to a place for care at the right time. We work to help you avoid trips to the emergency room that are not true emergencies and could be handled by your personal doctor, PCMH care team, or another health care facility. A special care coordinator is a part of your PCMH Care Team to help you get seamless access to care and avoid “the run-around”. In most cases, you can get an appointment to be seen by your PCMH Care Team on the same day that you call.
Your PCMH includes:
A dedicated personal physician.
An ongoing relationship with your personal physician, who will spend time getting to know you and your medical history.
Personalized care from a team, led by your personal physician, who takes shared responsibility with other team members for your ongoing care.
Quality of care to ensure that you have a good experience when you visit your PCMH.
Speedy and efficient treatment.
Improved access to care at the right place and time when needed.
One of the most important aspects of your PCMH is the focus on preventing you from getting sick and helping you to manage a healthy lifestyle. No matter what it’s called, the point of health care is to maintain your GOOD HEALTH, and that is what PCMH is all about.
To learn more about out the Patient Centered Medical Home (PCMH), please contact the Morehouse Choice ACO-ES at (770) 217-0997
aco_beneficiary_factsheet_7_2016 The links below will lead you to frequently-asked questions and information about Accountable Care Organizations (ACOs) and how they relate to your health care.
Video about Accountable Care Organizations and the “ACO Program” endorsed by Medicare: http://innovation.cms.gov/initiatives/ACO/
Basic Fact Sheet on ACOs (English): aco_beneficiary_factsheet_7_2016
Basic Fact Sheet on ACOs (Spanish/En Espanol): aco_beneficiary_factsheet_spa_7_2016