Welcome to Keystone ACO
What is an ACO?
An ACO (Accountable Care Organization) is a group of doctors, hospitals and other health care providers who agree to work together to give you improved health services and care. The ACO supports your doctor by making sure they have the most up-to-date information about your health care and services. In addition, the ACO can provide your doctor increased access to the expertise, staff, and technology needed to make sure your care is coordinated across all the places you get services. This is important to help you get the right care at the right time and to keep you healthy.
How will you know if your doctor has elected to participate in an ACO?
If you received a letter in the mail informing you of our new ACO, it is because your doctor or health care provider has elected to participate in the Keystone Accountable Care Organization — a new care coordination program from Medicare. The goal of the Keystone ACO is to provide you with improved coordinated care across care settings including hospital stays, doctors’ offices, rehabilitative centers, and long-term care facilities.
In addition to receiving a letter in the mail informing you that your doctor has elected to participate in the Keystone ACO, you will also be notified at your next Primary Care Doctor’s office visit. If you still are not sure if your doctor has elected to participate in an ACO, just ask at your next primary care visit.
How will your doctor’s participation in the Keystone ACO benefit you?
For the purpose of care coordination, Medicare will share certain information about your medical care with your doctor and the ACO, including medical conditions, prescriptions, hospital stays and doctor visits. This is important so that your doctor will have the information needed to track the services you have already received, understand where you may need more care, and find ways to smooth the path for you if you have to transfer in or out of a hospital, or from the care of one doctor to another. For you, this care coordination could mean less paperwork to fill out at the doctor’s office, avoiding unnecessary tests, or more help for you in dealing with any health conditions.
Are Medicare benefits changing because of the new Keystone ACO?
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.
What rights do you have if your doctor is participating in Keystone ACO?
You will continue to receive the same rights enjoyed by all people with ‘Fee for Service’ Medicare. Since your right to privacy remains very important, Medicare and the Keystone ACO have put safeguards in place to make sure all your health information is protected. Also, Medicare will not share any information about alcohol and drug treatment history, if you have received such treatment, unless you choose in writing to share it.
Can you still see your regular doctor?
Yes. You will continue to be able to see any doctor or health care provider who accepts Medicare.
What do you need to do if you are notified that your doctor is participating in Keystone ACO?
It is important to understand that your doctor, not you, is participating in the Accountable Care Organization, so you do not need to take any additional steps unless you choose not to allow Medicare to share your information for the purposes of care coordination.
How can you ask Medicare not to share your information with your doctor and Keystone ACO?
You can choose to prevent Medicare from sharing your general health information for the purpose of care coordination with your doctor and the ACO by taking one of the following actions:
- Call 1-800-MEDICARE (1-800-633-4227). TTY users should call
1-877-486-2048 - Complete and return the form enclosed with the letter you received in the mail to let the Keystone ACO know that you do not want Medicare to share your health information with them.
- When you are in your doctor's office complete a form that indicates you do not want Medicare to share your health information with the ACO.
Is there a deadline if you choose to decline?
If you choose to prevent Medicare from sharing your health information with your doctor and the Keystone ACO, the ACO 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.
More questions about the Keystone ACO program?
If you have any questions and would like to contact the Keystone ACO, please call 570-214-9492 or e-mail keystoneaco@keystoneaco.org.
For general information on ACOs, please contact Medicare at
1-800-MEDICARE (1-800-633-4227)
