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. Nobody—not your doctor, not your
hospital—can tell you who you have to see.
Is an ACO a Health Maintenance Organization (HMO), managed care, or an 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 limit your Medicare benefits. If your doctor participates
in a Medicare ACO, you always have the right to choose any doctor or
hospital who accepts Medicare at any time.Only people with Original
Medicare can be assigned to an ACO. You can’t be assigned to an ACO if
you have a Medicare Advantage Plan (like an HMO or a PPO).
How can I find a physician that is in an ACO?
Click here for a list of providers participating in the Princeton HealthCare Partners ACO.
How do I know if my doctor is in an ACO? What should I expect if my doctor is in an ACO?
If your doctor or health care provider chooses to participate in an ACO,
you’ll be notified. This notification might be a letter, written
information provided to you when you see your doctor, a sign posted in a
hospital, or it might be a conversation with your doctor the next time
you go to see him or her. If you aren’t sure if your doctor or health
care provider is participating in a Medicare ACO, ask him or her.
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.
Your Medicare benefits won’t be limited because your doctor is part of
an ACO. Also, you still have the right to choose any hospital or doctor
that accepts Medicare, at any time, even if that hospital or doctor
isn’t part of an ACO.
What rights do I have if my doctor is in an ACO?
You’ll continue to get the same rights all people with Medicare get. To
help you to get the best-coordinated and highest quality care, Medicare
will share certain information about your medical care with your
doctor’s 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 and
helping you get the right care.
Your privacy is very important to us. You can tell Medicare not to give
your doctor’s ACO information that your doctor needs to coordinate your
care by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call
1-877-486-2048. Unless you take this step, your medical information will
be shared automatically with your doctor’s ACO for purposes of care
coordination and quality improvement.
If you’re now getting or received treatment in the past for alcohol or
drug abuse, Medicare won’t share any information about that treatment
with any ACO unless the you give Medicare your written permission to do
Who can read my medical information, and will it be protected?
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.
The privacy and security of your medical information is protected by
federal law. Contact your doctor’s office for more information about how
they protect your medical information, or call 1-800-MEDICARE
(1-800-633-4227) 24 hours a day, 7 days a week. TTY users should call
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
won’t only know about the health issues that they’ve treated, 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?
Princeton HealthCare Partners, LLC
Address: 1 Plainsboro Road Plainsboro, NJ 08536
Compliance Line: 609.853.7900
ACO Primary Contact: Patricia Muniz, email firstname.lastname@example.org or call 609.853.7256