Accountable Care Organization
CFVH continues to participate in the CVS ACO (Accountable Care Organization). This organization, supported by the Centers for Medicare and Medicaid Services, looks for ways to reduce costs and maintain the same excellent service you have come to expect and we strive to provide.
The handout below outlines the specific purposes of the ACO and how you can get additional information should you have any questions. You can also call your local Family Medicine Network office for more information.
An ACO is a group of doctors and other health care providers who agree to work together with Medicare to give you the best possible 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 repeatedly.
No, 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.
The ACO shares information regarding past doctor, hospital, and pharmacy visits with your health care team. Your healthcare information helps the ACO track the services you’ve already received, understand where you may need more care, and find ways to smooth the transition from one physician to another.
Doctors in an ACO have greater access to the expertise, staff, and technologies they need to make sure your care is coordinated across all the places you receive services. For you, this coordination could mean less paperwork, avoiding unnecessary tests, and more assistance in managing health conditions.
We’re glad you’re having a positive experience already! Even though Doctor XX is participating in an ACO, you’ll continue to see him or her the way you have been. Doctor XX’s participation in an ACO doesn’t change your benefits in any way, and decisions about your care stay with you and Doctor XX.
Yes, that doesn’t change. You can always go to any doctor, hospital, or other provider that accepts Medicare. Nobody can restrict which providers you see.
As a patient, you do not participate in an ACO, only your doctor participates the ACO.
Absolutely nothing. Our health care organization is participating in the ACO, not you as a patient. Nothing about your Medicare benefits or coverage is changing.
As part of our ACO participation we have committed to improving care coordination for patients like you. To assist, CMS shares information about health care you have received outside of our organization. This allows us to know if other providers have already conducted tests or diagnostics to avoid repeating services as well as the opportunity to coordinate your overall plan of care with them.
As part of our participation in the ACO, Medicare provides our organization with information about all of the health care services you receive. This information is not being shared with organizations outside of the ACO. You have the right to request Medicare stop sharing this information at any time. Simply call 1-800-MEDICARE (1-800-633- 4227) and tell the operator your health care provider is participating in an ACO, and you don’t want to share your health care information with the ACO.
It’s important to know you can prevent Medicare from sharing this information at any time. Simply call 1-800- MEDICARE (1-800-633-4227) and tell the operator your health care provider is participating in an ACO, and you don’t want to share your health care information with the ACO. Medicare will then update your records to show that you don’t want to share your health care information. It will take about 45 days for this change to take effect.
No. If you have previously asked Medicare to stop sharing your health care information with the ACO that request remains valid. We are required to notify you of our ACO participation every year, but you do not need to contact Medicare if you have done so in the past.
Shelby Zenahlik, BSN,RN, Care Coordinator - (406) 826-4836
Sara Nestor, BSN, RN, Family Medicine Network Manager - (406) 826-4923
Katrina Strowbridge, BSN, RN, PI Manager/ACO Champion - (406) 826-4840