Accountable Care Organization

[misanman]

We just received a vague notice from the Medical Group where we receive much of our health care that they are part of an Accountable Care Organization. I think we may have heard something about this in the past but there was something a bit defensive about this notice that perked my interest.

The thing that caught my attention was the following: "An ACO is not an insurance plan, patients with Medicare that have doctors in an ACO retain all their rights and privileges under Medicare including the freedom to see any health care provider that accepts Medicare, even if that provider is not part of the ACO."

Despite their statement, I'm wondering if this "ACO" will serve as a fence of sorts around our medical care providers. Will we be pressured in subtle or not so subtle ways to stay within the ACO? What happens if we go for care outside of the ACO?

Does anyone have any actual experience with an ACO? How is it working in practice?

 

[braumeister]

Have you looked at this page from CMS?
It gives a lot of information on ACOs.

Accountable Care Organizations (ACOs): General Information

 

[misanman]

Aha -

When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.