What is an ACO?

An ACO (Accountable Care Organization) is a group of doctors, hospitals and other health care providers who work together to give you better service and care.  You may be a beneficiary of Silver State ACO if your doctor elected to participate in the ACO — a care coordination program from Medicare.  The doctor is a participant.  You are a beneficiary.

The goal is to provide you with improved health and patient experience, particularly if you're ever hospitalized or if you're living with a chronic condition. We will work with your provider to ensure that you receive important exams and immunizations, and that you're receiving the preventive care you need when you need it.

No. Your Medicare benefits and the cost of your coverage are not changing. You still have the right to choose to receive care from any doctor or hospital that accepts Medicare, at any time.

If you need treatment, we may help coordinate care among your doctors. We'll help ensure that your entire treatment team has access to the information they need to provide the best possible care for you. This may help improve outcome and/or eliminate duplicate tests and procedures.

Yes. You will continue to be able to see any doctor or health care provider who accepts Medicare.

You will continue to receive the same rights enjoyed by all people with Fee For Service ("Traditional") Medicare.  To help you get the best coordinated care, Medicare will share your medical information with your provider's ACO, including medical conditions, prescriptions, and visits to the doctor.  This is important to help your provider and the ACO keep up with your medical needs and track how well the ACO is doing to keep you healthy and help you get the right care.

As a beneficiary of Silver State ACO, you will also have to right to be admitted to a skilled nursing facility, should you need to, without first having been in the hospital for at least three days, which is generally a requirement in order for Medicare to pay for the skilled nursing facility stay.

To help Silver State ACO-affiliated doctors and hospitals, as well as other health care providers, give more coordinated care, Medicare shares personal health information on beneficiaries. This information will include visits to the doctor or hospital, medical conditions and prescriptions.

A provider and you continue to control the use of your personal information and your privacy is very important to us and, just like Medicare, we put safeguards in place to make sure all your health information is protected.

Medicare does not share information about anyone who has ever received treatment for alcohol or drug treatment without written permission. 

If you choose, you can decline to have your personal health information shared with us by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048

If you choose to prevent Medicare from sharing your health information with Silver State ACO, Medicare needs to be notified of your decision. However, if you do not decline now, you can choose to decline at any time in the future.

For general information on ACOs, please contact Medicare at 1-800-MEDICARE (1-800-633-4227)