What is an ACO?

ACOs must provide in-office notification of the provider’s participation in the ACO in settings in which the beneficiary receives primary care services. In addition to this, Indiana Lakes ACO has mailed information to those Medicare Fee-for-Service patients whose doctors and/or other healthcare providers are participating in the Indiana Lakes ACO.

You don’t need to do anything. You’ll still be in Original Medicare, and you’ll still have the right to use any doctor or hospital that accepts Medicare, at any time.

You still have the right to see any doctor or hospital that accepts Medicare, at any time.

You can continue receiving care from your doctor, or you can choose to see a doctor who doesn’t participate in an ACO. It is your choice.

It’s important to know:

• You are still in Original Medicare.
• You are still entitled to all the same Medicare services, benefits, and protections.
• You can still go to any doctor, hospital, or other provider that accepts Medicare. Nobody can restrict which providers you see.

You can still choose to go to any doctor, hospital, or other healthcare provider that accepts Medicare. Nobody – not even your current physician – can prevent you from seeing the doctors, hospitals or providers you want.

To help doctors who participate in an ACO give Medicare Fee-for-Service patients like you high quality care, Medicare wants to share some additional information about your care with them. This information includes things like doctor, hospital, and pharmacy visits in the past and moving forward. This information helps your doctor, and the other ACO providers, track the services you’ve already received, understand where you may need more care, and find ways to smooth the path for you if you have to transfer in or out of a hospital, or from the care of one doctor to another. If you decide you do not want to have the information about your care shared with the ACO, you can do so.

We value your privacy, so it’s important to know that you can prevent Medicare from sharing this information at any time.

• Call (800) MEDICARE (800-663-4227). TTY users should call (877) 486-2048 and tell the operator you are calling to tell Medicare that you do not want your information shared with any ACO.

Also, Medicare will not share any information about alcohol and drug treatment history, if you have received such treatment.

After your phone call is received, Medicare will update its records to show that you do not want to have your data shared. If you call (800) MEDICARE, you will receive a letter confirming this change. It will take about 45 days for this change to take effect.

If you change your mind in the future, you can call (800) MEDICARE (800-663-4227) and tell them that you have changed you mind and that you do want your data shared. You will receive a letter confirming this change.

To help you receive high quality care, Medicare shares general health information with the participating ACO, in this case your Indiana Lakes ACO physician. However, to protect your privacy, Medicare doesn’t share any information about treatment a Medicare Fee-for-Service patient received for alcohol and drug treatment with a participating ACO.

Medicare values your privacy. For that reason, you can prevent Medicare from sharing your personal health information, or otherwise change any of your preferences, at any time.

Call (800) MEDICARE (800-663-4227), and they can help you set your preferences the way you want them. You can also return the “Declining to Share Personal Health Information Form” to our doctor’s office.

Because you chose to enroll in a Medicare Advantage Plan, the notice you received about Accountable Care Organizations (ACOs) is no longer accurate. Please disregard it.

We’re glad you’re having a positive experience already. You can continue to see you doctor the way you have been. Your doctor’s participation in an ACO won’t change your benefits in any way, and decisions about your care stay with you and your doctor.

Doctors participating in ACOs may have improved access to the expertise, staff, and technology they need to make sure your care is coordinated across all the places you get services. For you, this coordination could mean less paperwork to fill out at the doctor’s office, avoiding unnecessary tests, or more help for you in dealing with any health conditions.

You do not need to take any additional steps to continue to receive care from your usual healthcare team. You’ll still be in Original Medicare, and you’ll still have the right to use any doctor or hospital that accepts Medicare, at any time.

It’s important to know that your doctor, not you, is participating in an Accountable Care Organization (ACO). You don’t have to fill out any forms or take any action to keep seeing your doctor.

The letter you got should include a form “Declining to Share Personal Health Information,” To help give you improved care, Medicare would like to share information about visits you made to doctors, hospitals, or pharmacies. This information can help your doctor and other healthcare providers give you the best possible care.

You can choose to prevent Medicare from sharing this information by either by calling 1-800 Medicare; or completing the form you got and returning it to your doctor’s office. You should fill this form out ONLY if you don’t want Medicare to share information.

For Spanish speaking patients, (800) MEDICARE (800-663-4227) can provide both a written version and verbal translation of this letter. For assistance in translating the letter to another language, (800) MEDICARE (800-663-4227) cannot provide you with a written version of the letter at this time. Please know that you can always call (800) MEDICARE (800-663-4227) to get the information verbally, over the phone.

We are sorry to hear about your loss. These letters were sent because of your relative’s history of receiving care from their physician who is participating in the Indiana Lakes ACO. You don’t need to do anything further – over time your relative will be removed from the list of patients affiliated with the participating physician.