Patient Centered Care

This letter explains your primary care provider, where you receive most of your healthcare, has teamed up
with other health care practitioners in a network called an Accountable Care Organization (ACO). An ACO
supports your provider in their goal of personalizing and improving your healthcare and offering access to
more services within the ACO’s network of clinicians.

An Accountable Care Organization (ACO) is a group of doctors, hospitals, and other health care providers
who accept Original Medicare (Parts A and B) and work together to coordinate your health care.

• You get patient-centered care focused on your needs.
• Your health care providers can see the same test results, treatments, and prescriptions.
• More coordination helps prevent medical errors and drug interactions.
• You may save time, money, and frustration by avoiding repeated tests and appointments.
• Better communication can help protect against Medicare fraud and waste.

ACO providers communicate with each other and partner with you in making health care decisions. This
sharing of information, sometimes through Electronic Health Records (EHRs), can help prevent repeated
medical tests and save you time on paperwork.

Imagine an ACO like a sports team. The ACO “team” can only win the championship when they give you
high-quality, coordinated care. Each player, from doctors to nurses to administrative staff, has a specific
position and skill set. The ACO leadership develops its playbook of strategies and makes sure there is
teamwork, communication, and collaboration among all players. Your primary care provider is the
quarterback of the team, making crucial decisions and coordinating your care with other team specialists.
The ultimate goal for a sports team is to win a championship; for an ACO, it’s to improve your overall health
and satisfaction. 

ACOs can provide benefits to patients in many ways, including (when applicable):

• For those who qualify, providing additional support services such as Care Management, which
could include creating a personalized care plan for the patient; helping patients self-manage their
medications; finding community resources for patients; etc.
• Offering computer, tablet, or phone visits (telehealth) for your convenience and to help prevent
hospital admissions.
• Admission to certain skilled nursing facilities any time you need therapy, even if you have not had a
3-day hospital stay.

You can check with your health care provider or the ACO to see what benefits are available to patients, like
you, who may qualify.

The name of the ACO may be different than the primary health care provider you see. ACOs are a network
of health care practitioners with several different participating medical providers, such as primary care
practices, hospitals, specialists, pharmacies, and other Medicare-enrolled providers that provide care for
patients. So, though you may not recognize the ACO’s name, you are receiving the letter because your
primary care physician or another healthcare provider you see is participating in the ACO. If you have
questions about the ACO listed on your letter, you may call their number that is provided in the letter or call
1-800-MEDICARE (1-800-633-4227. TTY users can call 1-877-486-2048.

No, we are not trying to sell you anything. There is no additional cost to you just because your health care
provider decided to partner with an ACO and there is absolutely no change to your Medicare benefits.
Your Medicare benefits are the same as they have been, and you will continue to have access to any
Medicare enrolled provider or supplier of your choice.

One of the most important benefits of your primary care physician’s participation in an ACO is that all your
doctors and other healthcare providers can communicate with each other about your overall healthcare
needs and work together to coordinate the best healthcare plan for you. By agreeing to share your personal
healthcare data in this way, you are helping to make sure all the healthcare professionals involved in your
healthcare have access to your complete health information when and where they need it. Your decision to
share your healthcare information allows all your healthcare professionals to work together to get you the
care you need.

If you decide you do not want Medicare to share your health care information with the physicians and
healthcare providers responsible for trying to take care of all your healthcare needs, you can call 1-800-
MEDICARE (1-800-633-4227) and “opt out” of data sharing. You will need to tell the representative you do
not want your personal healthcare information shared between all the healthcare providers trying to
service your healthcare needs. TTY users can call 1-877-486-2048. If you decide you do not want Medicare
to share your health care information with the doctors and professionals trying to service your healthcare
needs, you should understand Medicare will still use your healthcare information for some purposes, like
evaluating the financial performance of the healthcare services you received as well as the quality of care
you received. “Opting out” of data sharing does not mean you will stop receiving additional letters,
notifications and/or communications from the ACO.

An ACO is not a Medicare Advantage Plan, a health maintenance organization (HMO) plan or an insurance
plan of any kind. An ACO has an agreement with Medicare to be financially accountable for the quality, cost
and experience of care you receive from your health care provider. If you want to know more about the
differences between an ACO and a Medicare Advantage Plan, please go to the following website:
https://www.cms.gov/priorities/innovation/media/document/ma-vs-aco-fs-oct2022.