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OhioHealth Medicare Accountable Care Organization (ACO)

OhioHealth Medicare Accountable Care Organization (ACO)

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OhioHealth Medicare Accountable Care Organization (ACO)

Who we are

The OhioHealth Medicare ACO is a network of providers who have voluntarily come together to provide seamless, efficient, high-quality care to Medicare fee-for-service patients.

Focused on coordinating care across all healthcare settings, this patient-center model of healthcare delivery aligns physicians, hospitals, and payers in order to provide better access to care, better clinical quality, and cost management.

Coordinated care means doctors and other providers involved in your care will partner with you, and each other, to ensure that you receive the right care at the right time. This close communication supports our commitment to avoid unnecessary duplication of services and prevent medical errors. 

How the OhioHealth Medicare ACO works

Our physicians are rewarded for working together to improve quality of care while managing costs.

By bringing together the expertise of our doctors, the OhioHealth system of hospitals and care sites, and advanced medical technology, we make timely information available to you and your doctors so they can make better, more informed healthcare decisions.

Frequently Asked Questions

What is an 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.

How do I know if my doctor is participating in an ACO?

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.

Do I have to participate if my doctor is part of the OhioHealth Medicare ACO?

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. 

Can I still see all of my regular Medicare doctors and healthcare providers even though my doctor participates in an ACO?

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.

What information about me will the ACO have access to?

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 (1 (800) 633.4227). TTY users should call 1 (877) 486.2048. 

How can I decline to have my healthcare information shared?

Simply call 1-800 MEDICARE (1 (800) 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.

Why did my doctor choose to be in an ACO?

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.