Frequently Asked Questions

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 so.

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 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 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?

Visit CMS.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/.
Visit Medicare.gov/manage-your-health/coordinating-your-care/ accountable-care-organizations.html.
Call 1-800-MEDICARE 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.
 

Contact Us

Princeton HealthCare Partners, LLC
Address: 1 Plainsboro Road Plainsboro, NJ 08536
Compliance Line: 609.853.7900
Email: princetonhealthcarepartners@princetonhcs.org
ACO Primary Contact: Patricia Muniz, email pmuniz@princetonhcs.org or call 609.853.7256