MEDICARE BENEFICIARIES

Improving the Coordination of Your Medicare Benefits and Providers to Deliver Better Outcomes for You

Your doctors try hard to give you high-quality care when you or your loved one resides in a long-term care facility, but it can be a challenge to juggle information.  Medicare wants to make sure your doctors have the resources and information they need to coordinate your care. Working together with Medicare, your primary care clinician has decided to participate with our Accountable Care Organization (ACO), called LTC ACO, to give better, more coordinated healthcare to patients and family members like you.

Our Benefits

If you or your loved one has Original Medicare and your doctor decides to coordinate with other healthcare providers through LTC ACO, you’ll benefit because they’ll work together to get you the right care, at the right time, in the right setting, whether that is inside or outside of the long-term care facility where you reside.

Coordinated care saves time and costs by avoiding repeated tests and unneeded appointments. It may make it easier to spot potential problems before they become more serious—like drug interactions that can happen if one doctor isn’t aware of what another has prescribed.

FREQUENTLY ASKED QUESTIONS

Can I still choose my doctor?
LTC ACO won’t limit your choice of healthcare providers.Your Medicare benefits aren’t changing. You still have the right to visit any doctor, hospital, or other provider that accepts Medicare at any time, just like you do now. Your doctor may make recommendations, but it’s always your choice on what doctors or hospitals you use.
Is an ACO a Medicare Advantage Plan?
An ACO is NOT a Medicare Advantage Plan, which is an “all in one” alternative to Original Medicare, offered by private companies approved by Medicare. An ACO is NOT an HMO plan, or an insurance plan of any kind.
Who can be assigned to LTC ACO?
Only people with Original Medicare can be assigned to LTC ACO. You can’t be assigned to LTC ACO if you have a Medicare Advantage Plan (like an HMO or a Preferred Provider Organization). You may be assigned to LTC ACO if your primary care clinician in the LTC Facility participates in LTC ACO.
How do I know if my doctor participates in LTC ACO?
Doctors who choose to participate in LTC ACO must display a poster that notifies you of your doctor’s participation in the ACO. This poster is found in a common area of the long-term care facility. The poster also informs you of your option to decline sharing your healthcare information by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Medicare beneficiaries assigned to LTC ACO will also receive an annual beneficiary notice via regular mail.

If you aren’t sure if your doctor is participating in LTC ACO, ask him or her during your visit. For general information about ACOs, call  1-800-MEDICARE (1-800-633-4227).
What should I expect if my doctor is in LTC ACO?
When your healthcare provider participates in an ACO, you should see better, more coordinated care over time. With LTC ACO, you’re the center of care, and your satisfaction is one of our goals. Over time, you may notice the following:
  • You don’t have to fill out as many medical forms that ask for the same information.
  • The healthcare 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 healthcare team.
  • The providers participating in LTC ACO will work with you to make sure their healthcare decisions reflect your preferences.
What are my rights if my doctor is in LTC ACO?
You’ll continue to have 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 unless you have called 1-800-MEDICARE to tell Medicare not to share your healthcare information with your doctor’s ACO or other ACOs. TTY users should call 1-877-486-2048. This information is important to help LTC ACO keep up with your medical needs and track how well LTC ACO is doing to keep you healthy.

Also, you may get a follow-up survey to ask about your experiences as a patient of a doctor who’s participating in LTC ACO. You’ll get a letter to let you know the survey is genuine. LTC ACO will use your feedback to help make sure you get high-quality care.

LTC ACO is required to respect your privacy so you have the option to tell us not to share your healthcare information. You must call 1-800-MEDICARE (1-800-633-4227) to tell Medicare not to share information about your care with LTC ACO or any other ACO. TTY users should call 1-877-486-2048. Unless you take this step, your medical information will be shared with LTC ACO for purposes of care coordination and quality improvement.
Will my medical information be protected?
Yes, your medical information will be protected. Federal law protects the privacy and security of your medical information. The group of doctors and other healthcare providers in LTC ACO working together on your behalf will be able to read your medical records, along with other office staff authorized to help coordinate your care. Each of your healthcare providers won’t only know about the health issues that they’ve treated; they’ll have a more complete picture of your health by sharing information with your other healthcare providers. Contact the LTC ACO at 1-800-906-8382 for more information about how we protect your medical information or call 1-800-MEDICARE (TTY users should call 1-877-486-2048) to learn more about how Medicare protects your medical information.
Where can I find more information about ACOs?
For more information about ACOs:
  1. Talk to your doctor.
  2. Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
  3. Visit Medicare.gov.
  4. Contact LTC ACO at 1-800-906-8382.