Patients FAQ
1. What does an ACO mean for me?
An ACO is a group of doctors, hospitals, and other health care providers who communicate with you and with each other to make sure you get the care you need when you're sick and the support you need to get and stay healthy. Unlike HMOs, managed care, and some insurance plans, an ACO can't tell you which health care providers to see or hospital to visit, and can't limit your Medicare benefits.
2. How do I know if my doctor is in the Commonwealth Health Quality Alliance?
Doctors or health care providers who choose to participate in an ACO must display a poster that notifies you of your doctor's participation in an ACO. It also informs you of your option to decline sharing your health care information by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
If you aren't sure if your doctor or health care provider is participating in a Medicare ACO, ask him or her during your visit. For general information about ACOs, call 1-800-MEDICARE.
3. Can I continue to see my doctor?
You can still choose any doctor. Your Medicare benefits won't be limited because your doctor is part of an ACO. You still have the right to choose any hospital or doctor that accepts Medicare, at any time, even if that hospital or doctor isn't a part of an ACO. Your doctor may make recommendations, but it's always your choice on what doctors or hospitals you use.
4. What happens to my health information?
You'll continue to have the same rights all people with Medicare get. To help you to get the best-coordinated and highest quality care, Medicare will share certain information about your medical care with your doctor's ACO, including medical conditions, prescriptions, and visits to the doctor unless you have called 1-800-MEDICARE to tell Medicare not to share your health care information with your doctor's ACO or other ACOs. This information is important to help the ACO keep up with your medical needs and track how well the ACO is doing to keep you healthy. Also, you may get a follow-up survey to ask about your experiences as a patient of a doctor who's participating in an ACO. You'll get a letter to let you know the survey is genuine. The ACO will use your feedback
to help make sure you get high quality care.
ACOs are required to respect your privacy so you have the option to tell us not to share your health care information. You must call 1-800-MEDICARE (1-800-633-4227) to tell Medicare not to share information about your care with your doctor's ACO or any other ACO. TTY users should call 1-877-486-2048. Unless you take this step, your medical information will be shared with your doctor's ACO for purposes of care coordination and quality improvement.
Federal law protects the privacy and security of your medical information. The group of doctors, hospitals, and other health care providers in the ACO working together on your behalf will be able to read your medical records, along with other office staff authorized to help coordinate your care. Each of your health care providers won't only know about the health issues that they've treated, they'll have a more complete picture of your health by sharing information with your other health care providers. Contact your doctor's office for more information about how they protect your medical information, or call 1-800-MEDICARE to learn more about how Medicare protects your medical information.
For more information about ACOs: