• Colorado Accountable Care FAQs

  • Frequently asked questions for people with Medicare.

    Medicare wants to ensure that all providers have the resources and information they need to coordinate care. That’s why we’re working with many doctors, hospitals and other health care providers that have decided to work together to provide better, more coordinated health care. They have decided to participate in Accountable Care Organizations (ACOs). 

    If your doctor, health care provider or hospital decides to coordinate with other doctors through an ACO, you’ll benefit because the doctors will be part of a better team. They will work together to get you the right care at the right time in the right setting. The following are some questions you may have. 

    What happens to my Medicare benefits?

    • Your Medicare benefits stay the same.
    • If you have traditional Medicare, you continue to have the right to use any physician, hospital or other provider who accepts Medicare, at any time.
    • We are not a Health Maintenance Organization (HMO). You do not need a referral from your primary care physician before being seen by a specialist or other Medicare provider.
    • We may continue to recommend that you see particular physicians or other providers for your specific health needs, but it’s always your choice about what physicians or other providers you use or hospitals you visit.

    How will Colorado Accountable Care benefit me?

    Colorado Accountable Care benefits Medicare Fee-for-Service patients regardless of their health care needs. Patients with chronic illnesses, such as diabetes, high blood pressure and high cholesterol, will find value through improved health coordination and personalized treatment plans. Healthy patients will notice an increased emphasis on maintaining a healthy lifestyle and recommendations for appropriate screenings and regular preventive care. As a result, Medicare Fee-for-Service patients can expect to reduce their risk for serious health complications and will enjoy improved health. 

    If my physician or other provider is in Colorado Accountable Care, can I still see whatever doctor I want?

    Absolutely. If your physician or other provider participates in Colorado Accountable Care, you can still see any health care provider who accepts Medicare. Nobody—not your physician or other provider, not your hospital—can tell you who you have to see.

    Is Colorado Accountable Care a Health Maintenance Organization (HMO), managed care or an insurance company?

    No. Colorado Accountable Care consists of physicians, hospitals and other health care providers who work together to provide you with better, more coordinated care. Physicians and other health care providers in Colorado Accountable Care communicate with you and with each other to make sure that you get the care you need when you are sick, and the support you need to stay healthy and well. Unlike HMOs, managed care or some insurance plans, Colorado Accountable Care can’t tell you which health care providers to see and can’t change your Medicare benefits. You always have the right to choose any physician, other provider or hospital who accepts Medicare at any time.

    How do I know if my physician or other provider is in Colorado Accountable Care?

    You will receive a letter from your primary care doctor. In addition, during your next appointment, your primary care physician will talk with you about Colorado Accountable Care and answer questions that you may have. There also will be posters about Colorado Accountable Care in your physician or other provider's waiting room as well as in our hospitals. In addition, your physician or other provider's front desk staff will have written information to hand to you. If you aren’t sure if your physician or health care provider participates in Colorado Accountable Care, ask him or her.

    What rights do I have if my physician or other provider participates in Colorado Accountable Care?

    You will continue to have the same rights enjoyed by all people with Medicare. To help you get quality coordinated care, Medicare will share information about your medical information with your physicians or other providers in Colorado Accountable Care, including medical conditions, prescriptions and visits to the physician or other provider. This is important to help your physician or other providers keep up with your medical needs and track how well they are doing to keep you healthy and help you get the right care.

    Your privacy is very important to Colorado Accountable Care and to Medicare. The privacy of your medical information is protected by federal law, and you may choose to have your name and other personal information removed from the information that Medicare shares with your physician or other provider by doing one of these things

    • Calling 1-800-MEDICARE (TTY users should call 1-877-486-2048); or
    • Signing a form that is included in a mailing from your physician or other provider, and that is also available in your physician’s or other provider's office.

    If you receive a letter from your physician or other provider, unless you take one of these steps, your medical information will be shared automatically starting 30 days from the date you are notified.

    How will Colorado Accountable Care lead to better care for me?

    When your health care providers have access to your health information and are able to share that information with one another, they can give you better, more coordinated care. Each of your health care providers will not only know about the health issues that they have treated, they will have a more complete picture of your health through communicating with your other health care providers.

    Over time, you should see better more coordinated health care from Colorado Accountable Care, where you are the center of care and your satisfaction is our goal.

    Resources

    For more information about Accountable Care Organizations (ACOs), you can visit the following Medicare websites: