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Accountable Care Organization

A sustainable model for rural healthcare

Morris Hospital and Healthcare Centers became an Accountable Care Organization (ACO) on January 1, 2015. Being part of an ACO is a way for Morris Hospital & Healthcare Centers to participate in the new Medicare payment system while achieving better quality care, reducing healthcare costs, and improving community health. The goals are to help patients manage chronic disease so they have improved outcomes and to reduce unnecessary or inappropriate healthcare spending. This is achieved through better communication between providers and new care coordination services for patients. These services include a Nurse Care Coordinator who works closely with physicians and staff to coordinate the care for you. To contact the care coordinator, call 815-705-7491.

 

What is an ACO?

An Accountable Care Organization (ACO) is a healthcare organization that has decided to become “accountable” for the quality and cost of the care it provides to Medicare Fee-for-Service patients. This will be done through new programs that improve care coordination.

According to Medicare, “the goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time.”

Coordinated care is especially difficult for rural communities because patients may receive care from specialists who are out of town. Communication between local providers and urban specialists is often incomplete, which is why care coordination is helpful.

Morris Hospital & Healthcare Centers is taking the initiative to improve communication to increase the quality of care you receive.

 

What is a Care Coordinator?

Some patients have especially complex conditions and may see doctors and specialists that work at more than one facility. Care Coordinators will actively work with patients to improve communication between all of the care providers, as well as the patient and their family/caregivers. They will meet regularly with patients and provide tools and training to help patients manage their conditions. They may also connect patients with local community resources and services.

 

Why should I share my information?

Morris Hospital & Healthcare Centers has adopted electronic medical records to keep your health information in a secure, private place which can be viewed by the healthcare providers that you allow to access your information. This is how we can communicate and coordinate care between providers, reducing the need for repeating procedures that have already been done at another location.

Because Morris Hospital & Healthcare Centers is an Accountable Care Organization, Medicare is now willing to share all of your billing history with your providers. The way things work today, your providers only know about the care you receive in their office. This is why tests are often repeated at different offices, and physicians may not know what drugs you are taking or what other health problems you may have.

Having a complete electronic health record, with information in one place from all of your providers, will improve your overall care. Your provider will have the information that he or she needs to take the best possible care of you.

 

Who has access to my information?

Your local health care team, including your primary care provider, care coordinator, and office staff authorized to help coordinate your care.

 

What type of data will the ACO receive?

Medicare will only provide the ACO with claims records. Claims records have information about what services Medicare has paid for, the date and location that the services were provided, and the cost. Medicare will not share laboratory or test results. Medicare will not share information about anyone who has ever received treatment for alcohol or substance abuse without written permission.

 

Will my Medicare benefits change?

No. What you pay, your Medicare benefits, or the cost of your coverage will not increase due to your doctor’s participation in an ACO.

 

If my doctor is in an ACO, can I see whatever doctor I want?

Yes! You can continue to see any healthcare provider who accepts Medicare.

 

How can I decline to have my information shared?

You can call Medicare at 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048. Tell the operator you are calling about ACO’s.

 

Can I change my mind?

Yes! You can always change your mind. If you have previously declined, and now you’ve decided that you want your information shared with the ACO, call Medicare at 1-800-MEDICARE (1-800-633-4227) and tell them that you would like to share your claims data with the ACO. TTY users should call 1-877-486-2048.

 

Questions?

Contact the Nurse Care Coordinator at Morris Hospital at (815) 705-7491 or (815) 705-7813, or contact the Population Health Nurse at (815) 705-1083.