Learning about an Accountable Care Organization (ACO)
What is an ACO?
Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to the Medicare patients they serve. Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors.
What happens when an ACO is successful?
When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.
The Centers for Medicare and Medicare Services (CMS) website explains, “When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, the ACO will share in the savings it achieves for the MSSP. ACO formation also creates additional earning opportunities within the Medicare Fee for Service populations.”
For more resources and information visit Shared Savings Program | CMS and Accountable Care Organizations (ACOs): General Information | CMS
Medicare Beneficiary Notice
If your provider chooses to participate in an ACO, you will be notified. Notifications could include:
- Sign or poster in a clinic
- Written information provided at the time of a visit
- English/Spanish letters
Opting Out of an ACO
Beneficiaries have the right to contact Medicare at any time with questions or concerns, or to opt out of data sharing with the ACO.
- If you wish to continue participation as is, there is nothing you need to do.
- If you wish to continue seeing all of your same providers, you may do so and there is nothing you need to do.
- If you wish to opt out of sharing your claims data, you may do so and continue to see your same providers.
- If you wish to not have your clinical data shared, you can call Medicare and tell them your health provider is part of an ACO and you don’t want Medicare to share your health care information. Only you can make this call, so we encourage you to do so, if that is your wish.
- Call 800 MEDICARE (800-633-4227)
- TTY users 1-877-486-2048