Frequently Asked Questions

What is an ACO?

An Accountable Care Organization (ACO) is a group of health care providers who come together voluntarily to give high quality coordinated care to their Medicare fee-for-service patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. Medicare ACOs operate under the Medicare Shared Savings Program (MSSP).

If my doctor is in an ACO, can I still see whichever doctor I want?

Absolutely—if your doctor participates in an ACO, you can see any health care provider who accepts Medicare. No one can tell you which doctor you have to see.

Is an ACO a Health Maintenance Organization (HMO), managed care, or insurance company?

No. An ACO is a group of doctors, hospitals, and other health care providers who work together to provide you with better, more coordinated care. Doctors and hospitals in an ACO communicate with you and with each other to make sure that you get the care you need when you’re sick and the support you need to stay healthy and well.
An ACO isn’t an HMO, managed care, or insurance company. Unlike HMOs, managed care, or some insurance plans, an ACO can’t tell you which health care providers to see and can’t change your Medicare benefits. If your doctor participates in a Medicare ACO, you always have the right to choose any doctor or hospital that accepts Medicare at any time.

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

If your doctor or health care provider chooses to participate in an ACO, you will see a sign posted in his/her office. You can also check to see if your doctor is in an ACO here or by calling 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.

How does an ACO benefit me?

Over time, if you see a doctor or health care provider participating in an ACO, you may notice that:

  • You don’t have to fill out as many medical forms that ask for the same information.
  • The health care providers that you see all know what’s going on with your health because they communicate with each other.
  • You don’t need to repeat medical tests because your results are shared among your health care team.
  • The providers participating in the ACO will work with you to make sure the care decisions reflect your preferences.
  • You will have better control over your health care.
  • You will receive better care from your doctors because they will have better information about your medical history and can communicate more readily with your other doctors.

Do I have to pay more if my doctor is in an ACO?

No, the cost of your coverage and what you pay for doctor’s appointments does not change if your doctor participates in an ACO.

What rights do I have if my doctor is in an ACO?

You’ll continue to have the same rights all Medicare beneficiaries have. To help you to get the best coordinated care, Medicare will share certain information about your medical care with the ACO including medical conditions, prescriptions, and visits to the doctor. This is important to help the ACO keep up with your medical needs and track how well the ACO is doing to keep you healthy with appropriate care. Your privacy is very important to us. You can restrict the type of information Medicare shares with your ACO doctor for care coordination by calling 1-800-MEDICARE. TTY users should call 1-877-486-2048.

Who will have access to my medical information, and will it be protected?

The privacy and security of your medical information is protected by federal law. Only the group of doctors, hospitals, and other health care providers working together in the ACO will be able to read your medical records, along with other office staff authorized to help coordinate your care. For more information about how your medical information is protected in an ACO call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week TTY users should call 1-877-486-2048.

How will an ACO lead to better care for me?

When your health care providers have access to your health information and are able to share that information with one another, they can give you better, more coordinated care. Each of your health care providers will know about the health issues that they’ve treated and also they’ll have a more complete picture of your health through communicating with your other health care providers. When your health care providers participate in an ACO, you should see better, more coordinated care over time. With an ACO, you’re the center of care, and your satisfaction is one of their goals.

Where can I find more information about ACOs?

  • Call the Partners In Care ACO at (732) 246-0291
  • Visit How ACOs Work
  • Talk to your doctor.
  • Call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week.