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Just Hanging Around
posted
Got a letter in the mail yesterday about these. I don’t know how long they have been around, this is the first I’ve heard of them. Seems it only pertains to Medicare. It isn’t an insurance, and you can do whatever your insurance allows you to do.
From the website:

Accountable Care Organizations (ACOs)
What is an ACO?

ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients.

The goal of coordinated care is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.

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

I don’t have any problems with the care I’m receiving now, and other than going over your medical history every time you see a different doctor, I don’t see any advantages or disadvantages for me. Seems like it’s more of a benefit for the providers.

Is anyone enrolled in an ACO, any thoughts?
 
Posts: 3220 | Location: NE Kansas | Registered: February 24, 2007Reply With QuoteReport This Post
Seeker of Clarity
Picture of r0gue
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I work for a company that has one. It's an arrangement between providers (doctors/hospitals) and payors (insurance companies/medicare) to share risk, and if cost savings are realized, to share the savings. High cost diseases offer real opportunity in keeping after people that can't or won't take care of themselves.

If you're offered to be in one, my guess it is would mean improved preventative care and more frequent availability of certain preventative or care management services. I think your goals are aligned so long as you have all of the same freedoms to access care when you wish. They want to keep you out of the Emergency Room. They want to keep your disease or condition from worsening to the point where it requires higher levels of care.




 
Posts: 11354 | Registered: August 02, 2004Reply With QuoteReport This Post
Member
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It is a form of managed care. I prefer to manage my own care and choose my physicians and specialists. Traditional Medicare allows for choice.
 
Posts: 17177 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
Just Hanging Around
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quote:
Originally posted by ZSMICHAEL:
It is a form of managed care. I prefer to manage my own care and choose my physicians and specialists. Traditional Medicare allows for choice.


According to their literature, I can go to whoever I want for specialized care, and pick whoever I want as a primary care physician. If I want to go to Stormont Vail or St Francis for a procedure, it’s up to me. The ACO isn’t picking anything.
 
Posts: 3220 | Location: NE Kansas | Registered: February 24, 2007Reply With QuoteReport This Post
Bookers Bourbon
and a good cigar
Picture of Johnny 3eagles
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Sounds a lot like an HMO.



BIDEN SUCKS.

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Don't slow down. If you're scared don't show it.
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Posts: 7120 | Location: Arkansas  | Registered: November 06, 2010Reply With QuoteReport This Post
Just Hanging Around
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quote:
Originally posted by Johnny 3eagles:
Sounds a lot like an HMO.


But, with an HMO, don’t you have to go to your primary care physician and get a referral to go anywhere else?

This isn’t like that. I can go to any doctor that accepts Medicare.
 
Posts: 3220 | Location: NE Kansas | Registered: February 24, 2007Reply With QuoteReport This Post
Member
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quote:
But, with an HMO, don’t you have to go to your primary care physician and get a referral to go anywhere else?

^^^^^^^^^^
That depends. The devil is in the details. It seems like it is a form of capitation. Read the policy in its entirety. I do not see where the patient gets to share in the money that is saved.
 
Posts: 17177 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
Just Hanging Around
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That is an accurate statement.

Any monetary benefits go to the organization. All they seem to be promising is accurate diagnosis and preventative care. The better they do their job, the more money they get.
But between medicare, and my supplimental insurance, I haven't paid a penny for anything since I turned 65, and I've had a foot of my colon removed, and a back surgery
 
Posts: 3220 | Location: NE Kansas | Registered: February 24, 2007Reply With QuoteReport This Post
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