What is Medicare Shared Savings Program Berkshire Accountable Care Organization (ACO)?

Berkshire ACO is the new method of health care delivery for Medicare patients as of January 1, 2018. Our ACO is a group of physicians, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.

What’s An Accountable Care Organization (ACO)?

• An ACO is a group of doctors and other health care providers who voluntarily work together with Medicare to give you high quality service and care at the right time in the right setting. This physician practice is participating in the Berkshire Accountable Care Organization, a Medicare Shared Savings Program ACO.
• An ACO is not a Medicare Advantage Plan, (like an HMO or PPO), or an insurance plan.
• ACOs don’t change your Medicare benefits.

How Will An ACO Help My Doctor Coordinate My Care?

• Your doctors will have a more complete picture of your health through talking with your other doctors.

• To help you get better, more coordinated care, Medicare will share certain health information with us about the care you get from your doctors and other health care providers unless you ask Medicare not to share it. Medicare may also share your health information with other ACOs in which your other doctors or health care providers participate.
• This practice may continue to recommend that you see particular doctors for your specific health needs, but it’s always your choice about what doctors you see or hospitals you visit.

What Do I Need To Do?

• If you want Medicare to share information about the health care you received with the Berkshire ACO or with other ACOs in which your other doctors or health care providers participate, there’s nothing more you need to do.

• If you do not want Medicare to share your health care information, you need to call            1-800 MEDICARE (1-800-633-4227) and tell the representative that your doctor is part of an ACO and you don’t want Medicare to share your health care information. TTY users should call 1-877-486-2048.

• If you change your mind in the future, you can call 1-800-MEDICARE and tell the representative what you have decided. We can’t communicate with Medicare on your behalf.

• Even if you decline to share your health care information, Medicare will still use your information for some purposes, like assessing the financial and quality of care performance of the providers participating in ACOs. Also, Medicare may share some of your health care information with ACOs when measuring the quality of care given by health care providers participating in those ACOs.
  

Berkshire ACO is comprised of all Berkshire Health Systems physician providers and below outlined private practice organizations:

• Advanced Berkshire Medical Imaging
• Brien Center
• Berkshire Faculty Services
• Berkshire Orthopaedic Associates
• Berkshire Medical Center
• Berkshire Hand to Shoulder
• Contemporary Rheumatology
• Fairview Hospital
• Green Mountain Neurology
• Western MA Pathology

Questions

If you have questions or concerns, call our office, or we can discuss them next time you’re in our office. At that time, you may request a copy of our Beneficiary Information Notice that offers more information about ACOs and care coordination.  

You can also call 1-800-MEDICARE and tell the representative you’re calling to learn more about ACOs, or visit Medicare.gov/acos.html.