Jack's Blog on Medicare Plan Choices

What is a Medicare Accountable Care Organizations? Let me explain in simple terms:

An ACO is a group of doctors, hospitals, and other healthcare providers who work together to give you better, more coordinated care. Here’s how it works:

1. Instead of seeing different doctors who don’t talk to each other, an ACO tries to get all your healthcare providers to communicate and work as a team.
   
2. The goal is to keep you healthy and prevent problems, not just treat you when you’re sick.
   
3. Your doctors share information, so you don’t have to repeat tests or get conflicting advice.
   
4. You keep all your Medicare rights and benefits. You can still see any doctor who accepts Medicare, even if they’re not in the ACO.
   
5. If the ACO provides good care while saving money, they might get to share in those savings. This encourages them to be efficient.
   
6. Being part of an ACO doesn’t change your Medicare costs.

The main idea is to improve your care by having your healthcare providers work together more closely. You don’t have to do anything special – if your doctor is part of an ACO, you’ll automatically get the benefits.

Here is my take as someone who spent 30 years in the medical field, most of it as a Respiratory Care Provider (RCP) in homecare.  You want to work with doctors who want to keep you out of the hospital.

What if you have a Medicare advantage Plan?

Medicare Advantage plans and Accountable Care Organizations (ACOs) interact in an interesting way. Here’s how it works:

Medicare Advantage plans are offered by private insurance companies as an alternative to Original Medicare. These plans often have their own networks of providers and care coordination systems. ACOs, on the other hand, are primarily designed to work with Original Medicare.

If you have a Medicare Advantage plan:

1. Your plan may already have features similar to an ACO, such as coordinated care and a network of providers working together.

2. Some Medicare Advantage plans partner with ACOs to enhance their care coordination and quality improvement efforts.

3. If your Medicare Advantage plan works with an ACO, you might benefit from the ACO’s care coordination strategies, but this would be managed through your plan rather than directly through Medicare.

4. The specific benefits and how the ACO model is implemented can vary depending on your particular Medicare Advantage plan.

5. Unlike with Original Medicare, where you’re automatically assigned to an ACO if your primary care doctor is part of one, with Medicare Advantage, your involvement with an ACO would depend on your plan’s arrangements.

6. The cost savings and quality improvements that ACOs aim for might be reflected in your Medicare Advantage plan’s offerings or premiums, but this can vary by plan.

Before choosing an Advantage or Supplement plan, ensure you have a thorough understanding of Medicare itself. When it’s time to explore your options, don’t fall for a sales pitch from a single company or an agent representing only one provider.

At “More Plans More Choices,” I can provide you with side-by-side comparisons from various insurance carriers. More carriers plus more plans equals more choices.

Call me toll free at (888) 883-6074

Here is my disclaimer.  I gather most of my information from Medicare.gov and to the best of my knowledge, it is accurate.  Please use this information as a guideline and double check it yourself as I am only an average man at my best.